Dikmen S S, Temkin N R, Machamer J E, Holubkov A L, Fraser R T, Winn H R
Department of Rehabilitation Medicine, University of Washington, Seattle.
Arch Neurol. 1994 Feb;51(2):177-86. doi: 10.1001/archneur.1994.00540140087018.
Determine rates of, and factors predictive of, return to work in patients with civilian traumatic head injuries.
Inception cohort study with 1- to 2-year follow-up.
Hospitalized patients in a level I trauma center.
Three hundred sixty-six hospitalized head-injured subjects who were workers before injury and 95 comparison subjects participated in prospective, longitudinal investigations of employment following head injury. Head-injured and comparison subjects were similar on basic demographics and preinjury employment status. The comparison subjects consisted of patients who sustained traumatic injury to the body but not to the head.
Time taken to return to work following head injury.
Survival methodology was used for analysis. Whether patients returned to work and when related to both the characteristics of the injured patients (eg, education, preinjury work history), the severity of head injury and associated neuropsychologic problems, and severity of other system injuries. More precise predictions were possible using the multivariate model.
The present study provides a means of assessing employment potential predictively. This can be useful for clinical and research purposes. The results should be used cautiously and should stimulate discussions of appropriate use of services and resources to meet individual patients' needs.
确定 civilian 创伤性脑损伤患者的重返工作率及预测因素。
起始队列研究，随访 1 至 2 年。
一级创伤中心的住院患者。
366 名受伤前为工人的住院颅脑损伤受试者以及 95 名对照受试者参与了颅脑损伤后就业情况的前瞻性纵向调查。颅脑损伤受试者与对照受试者在基本人口统计学和伤前就业状况方面相似。对照受试者包括身体遭受创伤但头部未受伤的患者。
颅脑损伤后重返工作所需时间。
采用生存方法进行分析。患者是否重返工作以及何时重返工作与受伤患者的特征（如教育程度、伤前工作史）、颅脑损伤的严重程度及相关神经心理问题以及其他系统损伤的严重程度均有关。使用多变量模型可进行更精确的预测。
本研究提供了一种预测性评估就业潜力的方法。这对临床和研究目的可能有用。结果应谨慎使用，并应激发关于合理使用服务和资源以满足个体患者需求的讨论。
