Predictors of Return to Work in the First Year after Severe Traumatic Brain Injury: A Prospective, Observational Cohort Study

Research Objectives: To investigate clinical and sociodemographic factors associated with return to work (RTW) 1 year after severe Traumatic Brain Injury (TBI)

Design: Prospective observational cohort study with 12 months follow up.

Setting: Trauma Reference Center.

Participants: A total of 135 individuals were included in the study. Out of these, 97 individuals completed the 12-month follow-up.

Interventions: N/A.

Main Outcome Measures: Return to work was assessed via telephone interviews 6 and 12 months after severe TBI.

Results: The mean age was 40.3 ± 18.0 years, and 90.7% of the participants were male. The mean Injury Severity Score (ISS) was 32 ± 12, and the average length of stay on Mechanical Ventilatory Support was 10 ± 9 days. Fifty percent of the individuals had a low level of education. RTW was observed in 23.7% of the participants at 6 months after severe TBI and 32.9% at 12 months. On the binomial logistic regression model, physical aggression as the cause of injury, length of stay on Mechanical Ventilatory Support, and a high level of education were associated with a higher probability of returning to work 6 months after severe TBI. Additionally, at 12 months after trauma, physical aggression as the cause of injury (OR = 7.222, 95%CI 1.074-48.577), ISS score (OR = 0.934, 95%CI 0.883-0.987), performance of decompressive craniectomy (OR = 11.098, 95%CI 1.706-72.180), job security (OR = 4.931, 95%CI 1.086-22.393), and a high level of education (OR = 22.203, 95%CI 3.372-145.182) were associated with a higher probability of returning to work.

Conclusions: According to this study, the marjotity of patients with severe TBI do not return to work one year after their injury. Disability and cognitive impairments are the primary factors that contribute to the challenges faced by these individuals in reintegrating into social life. This study has certain limitations, including a relatively small group size, a single-center configuration, and unmeasured covariates that may have influenced the final results.

Author(s) Disclosures: All authors denied any conflicts of interests.