A systematic review and meta-analysis of return to work after mild Traumatic brain injury

ABSTRACT

Objective: To perform a systematic review and meta-analysis of return to work (RTW) times for adult patients with mild traumatic brain injury (mTBI).

Methods: Six databases and six trials registries were searched. Inclusion: studies reporting RTW, > 30 patients, adults, with mTBI. Exclusion: final measurement RTW < 30 days after injury, first measurement > 1 year.

Results: Of 978 records, 14 eligible studies were identified. Two included patients exclusively in paid employment pre-injury; four included paid employment, students, homemakers or other activities; seven included pre-injury occupational status described but unclear; one included patients whose pre-injury occupational status not described. Three reported average RTW, 12 reported proportions of patients RTW at pre-specified time-points (1 both). Average RTW times varied from 13 to 93 days. At 1 month the proportion of patients RTW (three pooled studies) was 0.56 (95% CI 0.30–0.79), at 6 months (six studies) 0.83 (0.74–0.89), at 12 months (seven studies) 0.89 (0.83–0.93).

Conclusion: More than half of patients with mTBI have returned to work by 1 month after injury, and more than 80% by 6 months. Most studies had poor internal validity. Reporting of outcomes in mTBI is variable, and this accounted for some of the heterogeneity found in this review.

KEYWORDS:

• Mild traumatic brain injury
• (mild TBI)
• concussion
• return to work
• employment
• vocational

Acknowledgement

The authors would like to thank Genny Franklin for her assistance in supporting us with literature searches.

Disclosure Statement

The authors report no declarations of interest.

Supplementary material

Supplemental data for this article can be acessed here.

Additional information

Funding

This study was performed with departmental funds.