Craig Hospital, Denver, Colorado (Drs Pretz, Whiteneck, and Ketchum); Traumatic Brain Injury Model Systems National Statistical and Data Center, Englewood, Colorado (Drs Pretz, Whiteneck, and Ketchum and Mr Kowalski); Swedish Ridge Medical Center, Englewood, Colorado (Dr Cuthbert); National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR)/Administration for Community Living, Washington, District of Columbia (Dr Miller); Departments of Rehabilitation and Human Performance (Dr Dams-O'Connor) and Neurology (Dr Dams-O'Connor), Icahn School of Medicine at Mount Sinai, New York, New York.
J Head Trauma Rehabil. 2020 Mar/Apr;35(2):140-151. doi: 10.1097/HTR.0000000000000506.
Return to work and school following traumatic brain injury (TBI) is an outcome of central importance both to TBI survivors and to society. The current study estimates the probability of returning to productivity over 5 years following moderate to severe brain injury.
A secondary longitudinal analysis using random effects modeling, that is, individual growth curve analysis based on a sample of 2542 population-weighted individuals from a multicenter cohort study.
Acute inpatient rehabilitation facilities.
Individuals 16 years and older with a primary diagnosis of TBI who were engaged in school or work at the time of injury.
Participation in productive activity, defined as employment or school, as reported during follow-up telephone interviews at 1, 2, and 5 years postinjury.
Baseline variables, age of injury, race, level of education and occupational category at the time of injury, disability rating at hospital discharge, substance abuse status, and rehabilitation length of stay, are significantly associated with probability of return to productivity. Individual-level productivity trajectories generally indicate that the probability of returning to productivity increases over time.
Results of this study highlight the importance of preinjury occupational status and level of education in returning to productive activity following moderate to severe TBI.
创伤性脑损伤(TBI)后重返工作和学校,这对 TBI 幸存者和社会都具有重要意义。本研究估计了中度至重度脑损伤后 5 年内恢复生产力的概率。
使用随机效应建模(即基于多中心队列研究中 2542 名具有代表性个体的个体增长曲线分析)进行二次纵向分析。
急性住院康复机构。
年龄在 16 岁及以上,在受伤时从事学校或工作,且有原发性 TBI 诊断的个体。
在受伤后 1、2 和 5 年的随访电话访谈中报告的生产性活动(定义为就业或上学)的参与情况。
基线变量(受伤年龄、种族、受伤时的教育程度和职业类别、出院时的残疾评定、物质滥用状况以及康复住院时间)与恢复生产力的概率显著相关。个体生产力轨迹普遍表明,随着时间的推移,恢复生产力的概率增加。
本研究结果强调了受伤前职业状况和教育程度在中度至重度 TBI 后恢复生产性活动中的重要性。