Research Reports - Employment stability in the first 5 years after traumatic brain injury

DominicDiSanto1RajKumarMPH12Shannon B.JuengstPhD34TessaHartPhD5Therese M.O'Neil-PirozziScD67NathanZaslerMD891011Thomas A.NovackPhD12ChristinaDillahunt-AspillagaPhD1314Kristin M.GrahamPhD9Bridget A.CotnerPhD1415AmandaRabinowitzPhD516SureyyaDikmenPhD1718JanetNiemeierPhD19Matthew R.Kesinger20Amy K.WagnerMD12122

Archives of Physical Medicine and Rehabilitation
Available online 26 July 2018

Objective
To characterize employment stability and identify predictive factors of employment stability in working-age individuals after moderate to severe traumatic brain injury (TBI) that may be clinically addressed.

Design
Longitudinal observational study of an inception cohort from the Traumatic Brain Injury Model Systems National Database (TBIMS-NDB) using data at years 1, 2, and 5 post-TBI.

Setting
Inpatient rehabilitation centers with telephone follow-up.

Participants
Individuals enrolled in the TBIMS-NDB since 2001, aged 18 to 59, with employment data at two or more follow-up interviews at years 1, 2, and 5 (N=5,683).

Interventions
Not applicable.

Main Outcome Measure
Employment stability, categorized using post-TBI employment data as no paid employment (53.25%), stably (27.20%), delayed (10.24%), or unstably (9.31%) employed.

Results
Multinomial regression analyses identified predictive factors of employment stability, including younger age, white race, less severe injuries, pre-injury employment, higher annual earnings, male sex, higher education, transportation independence post-injury, and no anxiety or depression at 1-year post-TBI.

Conclusions
Employment stability serves as an important measure of productivity post-TBI. Psychosocial, clinical, environmental, and demographic factors predict employment stability post-TBI. Notable predictors include transportation independence as well as presence of anxiety and depression at year 1 post-TBI as potentially modifiable intervention targets.

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