Alexis Ruet1,2, Claire Jourdan3,4, Eléonore Bayen5, Emmanuelle Darnoux6,7, Dalila Sahridj3, Idir Ghout6, Sylvie Azerad6, Pascale Pradat Diehl5, Philippe Aegerter6, James Charanton7, Claire Vallat Azouvi4,8, Philippe Azouvi3,4. 1. a Service de Médecine Physique et de Réadaptation , CHU de Caen , France. 2. b U1077, INSERM , Caen , France. 3. c Service de Médecine Physique et de Réadaptation , APHP, Hôpital Raymond Poincaré , Garches , France. 4. d EA 4047 HANDIReSP , Université de Versailles Saint-Quentin , France. 5. e Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière , Service de Médecine Physique et Réadaptation, Paris, France, Université Pierre et Marie Curie , Paris , France. 6. f Assistance Publique-Hôpitaux de Paris , Hôpital Ambroise Paré, Unité de Recherche Clinique (URC) , Boulogne , France. 7. g Centre Ressources Francilien du Traumatisme Crânien (CRFTC) , Paris , France. 8. h Antenne UEROS-SAMSAH 92-UGECAM IDF , Hôpital Raymond Poincaré , Garches , France.
Abstract
OBJECTIVE: To describe employment outcome four years after a severe traumatic brain injury by the assessment of individual patients' preinjury sociodemographic data, injury-related and postinjury factors. DESIGN: A prospective, multicenter inception cohort of 133 adult patients in the Paris area (France) who had received a severe traumatic brain injury were followed up postinjury at one and four years. Sociodemographic data, factors related to injury severity and one-year functional and cognitive outcomes were prospectively collected. METHODS: The main outcome measure was employment status. Potential predictors of employment status were assessed by univariate and multivariate analysis. RESULTS: At the four-year follow-up, 38% of patients were in paid employment. The following factors were independent predictors of unemployment: being unemployed or studying before traumatic brain injury, traumatic brain injury severity (i.e., a lower Glasgow Coma Scale score upon admission and a longer stay in intensive care) and a lower one-year Glasgow Outcome Scale-Extended score. CONCLUSION: This study confirmed the low rate of long-term employment amongst patients after a severe traumatic brain injury. The results illustrated the multiple determinants of employment outcome and suggested that students who had received a traumatic brain injury were particularly likely to be unemployed, thus we propose that they may require specific support to help them find work. Implications for rehabilitation Traumatic brain injury is a leading cause of persistent disablity and can associate cognitive, emotional, physical and sensory impairments, which often result in quality-of-life reduction and job loss. Predictors of post-traumatic brain injury unemployment and job loss remains unclear in the particular population of severe traumatic brain injury patients. The present study highlights the post-traumatic brain injury student population require a close follow-up and vocational rehabilitation. The study suggests that return to work post-severe traumatic brain injury is frequently unstable and workers often experience difficulties that caregivers have to consider.
OBJECTIVE: To describe employment outcome four years after a severe traumatic brain injury by the assessment of individual patients' preinjury sociodemographic data, injury-related and postinjury factors. DESIGN: A prospective, multicenter inception cohort of 133 adult patients in the Paris area (France) who had received a severe traumatic brain injury were followed up postinjury at one and four years. Sociodemographic data, factors related to injury severity and one-year functional and cognitive outcomes were prospectively collected. METHODS: The main outcome measure was employment status. Potential predictors of employment status were assessed by univariate and multivariate analysis. RESULTS: At the four-year follow-up, 38% of patients were in paid employment. The following factors were independent predictors of unemployment: being unemployed or studying before traumatic brain injury, traumatic brain injury severity (i.e., a lower Glasgow Coma Scale score upon admission and a longer stay in intensive care) and a lower one-year Glasgow Outcome Scale-Extended score. CONCLUSION: This study confirmed the low rate of long-term employment amongst patients after a severe traumatic brain injury. The results illustrated the multiple determinants of employment outcome and suggested that students who had received a traumatic brain injury were particularly likely to be unemployed, thus we propose that they may require specific support to help them find work. Implications for rehabilitation Traumatic brain injury is a leading cause of persistent disablity and can associate cognitive, emotional, physical and sensory impairments, which often result in quality-of-life reduction and job loss. Predictors of post-traumatic brain injury unemployment and job loss remains unclear in the particular population of severe traumatic brain injurypatients. The present study highlights the post-traumatic brain injury student population require a close follow-up and vocational rehabilitation. The study suggests that return to work post-severe traumatic brain injury is frequently unstable and workers often experience difficulties that caregivers have to consider.
Entities:
Keywords:
Traumatic brain injury; disability; employment; follow-up study; return to work
Authors: David N Borg; Jennifer Fleming; Joshua J Bon; Michele M Foster; Elizabeth Kendall; Timothy Geraghty Journal: BMC Health Serv Res Date: 2022-04-05 Impact factor: 2.655
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