Cifu D X, Keyser-Marcus L, Lopez E, Wehman P, Kreutzer J S, Englander J, High W
Department of Physical Medicine and Rehabilitation, Medical College of Virginia, Richmond 23298-0542, USA.
Arch Phys Med Rehabil. 1997 Feb;78(2):125-31. doi: 10.1016/s0003-9993(97)90252-5.
To investigate the influence of acute injury characteristics on subsequent return to work in traumatic brain injury (TBI) patients.
Descriptive statistics were performed in a comparative study of 49 TBI patients who were competitively employed at 1-year follow-up and 83 unemployed patients. Independent t tests were then performed to examine the differences between the two groups on specific measures including the Disability Rating Scale (DRS), Functional Assessment Measure (FIM), Rancho Los Amigos Scale (RLAS), Glasgow Coma Scale (GCS), Neurobehavioral Rating Scale (NRS), and neuropsychological test results.
Four medical centers in the federally sponsored Traumatic Brain Injury Model Systems Project that provide emergency medical services, intensive and acute medical care, inpatient rehabilitation, and a spectrum of community rehabilitation services.
Patients were selected from a national database of 245 rehabilitation inpatients admitted to acute care within 8 hours of TBI and seen at 1-year follow-up.
Return to work at 1-year follow-up.
Persons employed at 1-year follow-up obtained significantly better scores on specific acute measures of physical functioning (Admission FIM, Admission DRS, Discharge DRS), cognitive functioning (Logical Memory Delay), behavioral functioning (Admission RLAS, Discharge RLAS, NRS Excitement factor), and injury severity (Admission GCS, Highest GCS, Length of Coma, Length of PTA) than their unemployed counterparts.
Persons obtaining better scores on certain acute measures (e.g., Admission GCS) are more likely to return to the workforce. Future research should focus on developing a standardized tool to assess a patient's ability to return to work, as well as an operational definition for successful employment.
探讨急性损伤特征对创伤性脑损伤（TBI）患者随后重返工作岗位的影响。
对49例在1年随访时仍有竞争性工作的TBI患者和83例失业患者进行比较研究，并进行描述性统计。然后进行独立t检验，以检查两组在特定指标上的差异，这些指标包括残疾评定量表（DRS）、功能评估量表（FIM）、兰乔斯阿米戈斯量表（RLAS）、格拉斯哥昏迷量表（GCS）、神经行为评定量表（NRS）以及神经心理学测试结果。
联邦政府资助的创伤性脑损伤模型系统项目中的四个医疗中心，这些中心提供紧急医疗服务、重症和急性医疗护理、住院康复以及一系列社区康复服务。
患者选自一个全国性数据库，该数据库包含245例在TBI后8小时内入住急性护理病房且在1年随访时接受观察的康复住院患者。
1年随访时重返工作岗位情况。
在1年随访时有工作的患者在身体功能的特定急性指标（入院FIM、入院DRS、出院DRS）、认知功能（逻辑记忆延迟）、行为功能（入院RLAS、出院RLAS、NRS兴奋因子）以及损伤严重程度（入院GCS、最高GCS、昏迷时长、创伤后遗忘时长）方面的得分显著高于失业患者。
在某些急性指标（如入院GCS）上得分较高的患者更有可能重返工作岗位。未来的研究应侧重于开发一种标准化工具来评估患者重返工作岗位的能力，以及成功就业的操作性定义。
