Employment Stability in the First 5 Years After Moderate-to-Severe Traumatic Brain Injury

DiSanto, Dominic; Kumar, Raj G.; Juengst, Shannon B.; Hart, Tessa; OʼNeil-Pirozzi, Therese M.; Zasler, Nathan D.; Novack, Thomas A.; Dillahunt-Aspillaga, Christina; Graham, Kristin M.; Cotner, Bridget A.; Rabinowitz, Amanda R.; Dikmen, Sureyya; Kesinger, Matthew R.; Wagner, Amy K.

doi:10.1016/j.apmr.2018.06.022

Cited by 38 publications

(42 citation statements)

References 65 publications

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“…Past studies have reported employment rates that range from 8–72% in individuals with TBI during the first year after the injury [ 6 , 7 , 8 ]. Factors influencing employment status include age at the time of trauma [ 9 , 10 , 11 , 12 , 13 , 14 ], gender [ 9 , 12 , 15 , 16 , 17 ], ethnicity [ 17 ], marital or partner relationship status prior to injury [ 9 , 15 , 18 , 19 , 20 ], education level [ 8 , 10 , 13 , 19 , 20 , 21 , 22 ], previous employment status [ 8 , 10 , 13 , 15 , 18 , 21 , 23 , 24 , 25 ], occupation type [ 15 , 18 , 26 ], severity of the injury [ 8 , 11 , 13 , 14 , 15 , 18 , 23 , 27 , 28 , 29 , 30 ], cognitive functioning [ 11 , 14 , 16 , 27 , 31 ], depression status [ ...…”

Section: Introductionmentioning

confidence: 99%

Early Predictors of Employment Status One Year Post Injury in Individuals with Traumatic Brain Injury in Europe

Arango‐Lasprilla

Zeldovich

Olabarrieta‐Landa

et al. 2020

JCM

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Sustaining a traumatic brain injury (TBI) often affects the individual’s ability to work, reducing employment rates post-injury across all severities of TBI. The objective of this multi-country study was to assess the most relevant early predictors of employment status in individuals after TBI at one-year post-injury in European countries. Using a prospective longitudinal non-randomized observational cohort (The Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) project), data was collected between December 2014–2019 from 63 trauma centers in 18 European countries. The 1015 individuals who took part in this study were potential labor market participants, admitted to a hospital and enrolled within 24 h of injury with a clinical TBI diagnosis and indication for a computed tomography (CT) scan, and followed up at one year. Results from a binomial logistic regression showed that older age, status of part-time employment or unemployment at time of injury, premorbid psychiatric problems, and higher injury severity (as measured with higher Injury severity score (ISS), lower Glasgow Coma Scale (GCS), and longer length of stay (LOS) in hospital) were associated with higher unemployment probability at one-year after injury. The study strengthens evidence for age, employment at time of injury, premorbid psychiatric problems, ISS, GCS, and LOS as important predictors for employment status one-year post-TBI across Europe.

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Section: Introductionmentioning

confidence: 99%

Early Predictors of Employment Status One Year Post Injury in Individuals with Traumatic Brain Injury in Europe

Arango‐Lasprilla

Zeldovich

Olabarrieta‐Landa

et al. 2020

JCM

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“…ABI constitutes a variety of injuries such as traumatic brain injury (TBI) and non-traumatic causes (non-TBI), where the latter includes stroke, subarachnoid hemorrhage (SAH), CNS infection, encephalopathy, and brain tumor (1). ABI is among the most disabling conditions (2, 3) with potentially profound implications for the individual, family, and society, since it often leads to short- and long-term physical, communicative, cognitive, and emotional dysfunction. Consequently, the capability to return to work (RTW) or resume education (4–6) may be reduced, since it is highly dependent of physical, cognitive, communicative, and emotional functioning.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Return to Work After Acquired Brain Injury in Young Danish Adults: A Nation-Wide Registry-Based Cohort Study

et al. 2019

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Objective: (1) To determine patterns of return to work (RTW) after traumatic brain injury and other causes of acquired brain injury (ABI) among young adults aged 19–30 years and (2) to compare the stability of long-term labor-market attachment (LMA) to the background population.Method: Nationwide registry-based inception cohort study of 10 years weekly data of employment status. Patients (n = 8,496) aged 19–30 years with first-ever diagnosis of TBI, stroke, subarachnoid hemorrhage, encephalopathy, brain tumor, or CNS infections during 1999–2015. For comparison, a general population cohort (n = 206,025) individually matched on age, sex, and municipality was identified. The main outcome was RTW, which was defined as time to LMA, i.e., a week without public assistance benefits except education grants/leave. Stable labor-market attachment (sLMA) was defined as LMA for at least 75% over 52 weeks. The cumulative incidence proportions of RTW and stable RTW in the ABI cohort were estimated with the Aalen-Johansen estimator with death as a competing event.Results: Twelve weeks after diagnosis 46.9% of ABI cohort had returned to stable RTW, which increased to 57.4% 1 year after, and 69.7% 10 years after. However, compared to controls fewer had sLMA 1 year (OR: 0.25 [95% CI 0.24–0.27]) and 10 years after diagnosis (OR: 0.35 [95% CI: 0.33–0.38]). Despite significant variations, sLMA was lower compared to the control cohort for all subtypes of ABI and no significant improvements were seen after 2–5 years.Conclusion: Despite relatively fast RTW only a minor proportion of young patients with ABI achieves sLMA.

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“…TBI can profoundly impact complex behaviors, including self‐regulation, expression of appropriate social behaviors, affect recognition, and social communication . There has been extensive research into social and community integration after TBI, including return to employment, driving, social participation, and changes in life roles . Programs such as social competence training were designed to improve social skills to broadly facilitate social and community integration.…”

Section: Discussionmentioning

confidence: 99%

“…There has much research into the psychosocial consequences of TBI. For some individuals, TBI can lead to significant chronic cognitive and neurobehavioral impairments that impact the number and depth of social relationships, decrease participation in the community, employability, and driving independence . TBI‐related morbidity is also related to poorer long‐term mental and physical health, including an increased risk of depression, medical comorbidities, pain, and functional impairments .…”

Section: Introductionmentioning

confidence: 99%

Lifetime history of traumatic brain injury is associated with increased loneliness in adults: A US nationally representative study

Kumar

Ornstein

Bollens‐Lund

et al. 2020

Int J Geriat Psychiatry

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Background/Objectives An estimated 55 million individuals worldwide live with chronic disability associated with traumatic brain injury (TBI), which may include cognitive, behavioral, and social impairments. Reduced participation in social activities is common after TBI; however, few studies have evaluated loneliness among survivors of TBI. The current study aimed to evaluate the association between history of TBI and loneliness and to identify mediators of this association. Methods/Design Retrospective cohort study. Nationally representative sample of N = 724 adults over age 50 years (Health and Retirement Study). Loneliness was evaluated using the 11‐item Revised University of California Los Angeles (R‐UCLA) Loneliness Scale (range 11‐33). Lifetime history of TBI evaluated retrospectively using the Ohio State University TBI Identification Method. We included the following covariates: age, sex, race, and education; and mediators: depressive symptoms, number of comorbidities, chronic pain, difficulty with activities of daily living, and social network index. Results History of TBI was associated with a 1.28‐point (95% CI, 0.46‐2.11; P < .05; Cohen's D = 0.284) increase in R‐UCLA Loneliness Scale scores after covariate adjustment. Individuals with more recent injuries (within 10 years) and multiple lifetime TBIs reported the highest loneliness scores. In the structural equation model, depressive symptoms partially mediated the relationship between TBI and loneliness. All models were adjusted for US population sampling weights. Conclusions History of TBI was associated with greater loneliness compared with individuals without TBI in a representative sample of US adults. Managing depressive symptoms and medical consequences of TBI may be a target to ameliorate reporting of loneliness in this population.

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Employment Stability in the First 5 Years After Moderate-to-Severe Traumatic Brain Injury

Cited by 38 publications

References 65 publications

Early Predictors of Employment Status One Year Post Injury in Individuals with Traumatic Brain Injury in Europe

Early Predictors of Employment Status One Year Post Injury in Individuals with Traumatic Brain Injury in Europe

Long-Term Return to Work After Acquired Brain Injury in Young Danish Adults: A Nation-Wide Registry-Based Cohort Study

Lifetime history of traumatic brain injury is associated with increased loneliness in adults: A US nationally representative study

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