Research Reports - Employment outcome four years after a severe traumatic brain injury

Disabil Rehabil. 2017 May 18:1-8. doi: 10.1080/09638288.2017.1327992. [Epub ahead
of print]

Ruet A(1)(2), Jourdan C(3)(4), Bayen E(5), Darnoux E(6)(7), Sahridj D(3), Ghout
I(6), Azerad S(6), Pradat Diehl P(5), Aegerter P(6), Charanton J(7), Vallat
Azouvi C(4)(8), Azouvi P(3)(4).

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. 

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