Multi-level modelling of employment probability trajectories and employment stability at 1, 2 and 5 years after traumatic brain injury

Abstract

It could be wise to target patient population with these demographic and injury characteristics for more extensive follow-ups and vocational rehabilitation to help improve employment outcomes following injury.

Long-term employment outcomes following traumatic brain injury and orthopaedic trauma: A ten-year prospective study

“…Consistent with previous long-term studies, having a more severe TBI was associated with being unemployed or nonvocational, especially evident following extremely severe TBI (24,25). Studies of younger samples with severe TBI have suggested a declining influence of injury severity over 6-23 years post-injury (7,27), although a restricted range of TBI severity in these studies may have limited the apparent contribution of PTA.…”

“…This is consistent with reviews by Crépeau & Scherzer (31) and Ownsworth & McKenna (32), although Saltychev et al (33) described the evidence as weak. In long-term studies at least 5 years post-TBI, the influence of occupation type has been mixed (7,24,26), and 2 studies of major trauma excluding severe TBI found that education, but not occupation type, was significant in predicting employment at 5-7 years post-injury (10,11). Apart from one study (34), higher education has not generally been associated with better long-term employment following TBI (7,24,28,28,35).…”

“…In long-term studies at least 5 years post-TBI, the influence of occupation type has been mixed (7,24,26), and 2 studies of major trauma excluding severe TBI found that education, but not occupation type, was significant in predicting employment at 5-7 years post-injury (10,11). Apart from one study (34), higher education has not generally been associated with better long-term employment following TBI (7,24,28,28,35). Given the likely correlation between education and occupation type, as was evident in the current study, it is possible that each of these factors contributes to an individual's cognitive reserve (36) in coping with traumatic injury.…”

Participation in the workforce after a traumatic brain injury: a matter of control

“…Accordingly, cognitive or behavioural difficulties post-injury among one-third of individuals having had a TBI were found to interfere with re-entry to work [20]. Likewise, factors such as being unemployed pre-injury, severe brain injury and cognitive limitations are significant barriers [21,22]. After a TBI, pending people back to work is a multifacetted mission in rehabilitation programmes [23].…”

Predictors of Recovery From Posttraumatic Amnesia

“…2,3 This latter measure, first described in 1928 by Symonds 4 and later expanded upon by Russell and Smith, 5 has emerged as a strong predictor of TBI outcomes, surpassing the Glasgow Coma Scale in predictive value and leading some to call it the single best predictor of outcomes after TBI. 6,7 PTA has been shown to be a useful predictor of the following: subsequent functional level [8][9][10] ; cognitive recovery as assessed by neuropsychological test batteries, 11,12 measures of IQ, 13 driving skill, 14 and processing speed and executive function 15 ; subsequent unemployment at up to 5 years postinjury 16 ; overall cerebral atrophy 17 ; and social cognition as measured by facial emotion recognition 18 and tests of social inference perception. 19 Although early studies used retrospective assessments to pinpoint patients' emergence from PTA, current practice relies upon prospective measures such as the Galveston Orientation and Amnesia Test (GOAT) and the Orientation Log, which are designed for serial evaluation of orientation, recall, and new learning ability.…”