Sato Mamiko, Kobayashi Yasutaka, Fujita Kazuki, Hitosugi Masahito
Department of Rehabilitation Medicine, Fukui General Hospital, Fukui 910-8561, Japan.
Graduate School of Health Science, Fukui Health Science University, Fukui 910-3190, Japan.
Healthcare (Basel). 2021 Oct 29;9(11):1469. doi: 10.3390/healthcare9111469.
Many patients resume driving after brain injury regardless of their ability to drive safely. Predictors for resuming driving in terms of actual resumption status and environmental factors are unclear. We evaluated the reasons for resuming driving after brain injury and examined whether social environmental factors are useful predictors of resuming driving. This retrospective cohort study was based on a multicenter questionnaire survey at least 18 months after discharge of brain injury patients with rehabilitation. A total of 206 brain injury patients (cerebrovascular disease and traumatic brain injury) were included in the study, which was conducted according to the International Classification of Functioning (ICF) items using log-binominal regression analysis, evaluating social environmental factors as associated factors of resuming driving after brain injury. Social environmental factors, inadequate public transport (risk ratio (RR), 1.38), and no alternative driver (RR, 1.53) were included as significant independent associated factors. We found that models using ICF categories were effective for investigating factors associated with resuming driving in patients after brain injury and significant association between resuming driving and social environmental factors. Therefore, social environmental factors should be considered when predicting driving resumption in patients after brain injury, which may lead to better counseling and environmental adjustment.
许多脑损伤患者不顾自身安全驾驶能力就恢复了驾驶。关于实际恢复驾驶状态和环境因素方面恢复驾驶的预测因素尚不清楚。我们评估了脑损伤后恢复驾驶的原因，并研究了社会环境因素是否是恢复驾驶的有效预测因素。这项回顾性队列研究基于对脑损伤康复出院至少18个月后的患者进行的多中心问卷调查。共有206名脑损伤患者（脑血管疾病和创伤性脑损伤）纳入研究，该研究根据国际功能分类（ICF）项目，采用对数二项回归分析，将社会环境因素评估为脑损伤后恢复驾驶的相关因素。社会环境因素、公共交通不便（风险比（RR），1.38）和没有替代驾驶员（RR，1.53）被列为显著的独立相关因素。我们发现，使用ICF分类的模型对于调查脑损伤患者恢复驾驶的相关因素是有效的，并且恢复驾驶与社会环境因素之间存在显著关联。因此，在预测脑损伤患者恢复驾驶时应考虑社会环境因素，这可能会带来更好的咨询和环境调整。
