Return to work after severe traumatic brain injury: a national study with a one-year follow-up of neurocognitive and behavioural outcomes

ABSTRACT

The objectives were to investigate the frequency of return-to-work (RTW) one year after severe traumatic brain injury (sTBI: Glasgow Coma Scale, GCS 3–8) and to identify which demographic and injury-related characteristics and neurocognitive factors are associated with RTW. This study is part of a prospective national study on sTBI conducted in all four Norwegian Trauma Referral Centres, including patients aged >15 years over a period of three years (n = 378). For the purpose of this study, only pre-employed individuals of working age (16 to 67 years) were investigated for RTW (n = 143), and of these, 104 participants underwent neuropsychological testing. Measures of acute injury severity, neuropsychological composite scores (Memory, Processing Speed, Executive Functions) at the one-year follow-up, and the Behaviour Rating Inventory of Executive Functions (patient- and relative reports) were explored as predictors of RTW. The frequency of RTW was 54.5%. Multivariate logistic regression analyses identified younger age, shorter length of stay in intensive care, better Processing Speed scores, and lower levels of metacognitive difficulties as rated by relatives as significant predictors of RTW. Findings support the importance of neuropsychological measures in predicting long-term RTW and highlight the need to address neurocognitive and behavioural difficulties to improve RTW after sTBI.

KEYWORDS:

• TBI
• Employment
• Outcome assessment
• Behaviour
• Neuropsychological
• Executive functions

Acknowledgements

The authors thank all the patients and their families for participating. Our special thanks to all the neuropsychologists who were involved in collecting the neuropsychological data. Our warm thanks to Tone Jerstad, neuroradiologist, and other neuroradiologists at the trauma hospitals for the classification of the CT scans. We are grateful to Claire Jourdan, MD, for her time and insightful input.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by The Research Council of Norway, Grant number 185267, and The Research Council of Norway, Project number 209748.