Vocational/educational prognosis in adolescents and young adults with acquired brain injury: a nationwide cohort study

ABSTRACT

Objective

To determine prognostic factors for work ability and employment/educational status among young patients referred to outpatient neurorehabilitation clinics after an acquired brain injury.

Methods

A nationwide cohort study of 471 15–30-year-old patients who attended an interdisciplinary clinical assessment and provided questionnaire data at baseline and after one year. The outcomes were the Work Ability Score (WAS, 0–10 (best)) and employment/educational status after one year. Prognostic performance was analyzed using univariable regression and multivariable Ridge regression in a five-fold cross-validated procedure.

Results

Preinjury, 86% of the patients were employed, while the percentage had decreased to 55% at baseline and 52% at follow-up. The model, which included clinical measures of function, showed moderate prognostic performance with respect to WAS (R²=0.29) and employment/educational status (area under the curve (AUC)=0.77). Glasgow Outcome Scale Extended (R²=0.15, AUC=0.68) and the cognitive subscale of the Functional Independence Measure (R²=0.09, AUC=0.64), along with fatigue measured with the Multidimensional Fatigue Inventory (R²=0.15, AUC=0.60) were the single predictors with the highest predictive performance.

Conclusion

Despite generally high scores in motor and cognitive tests, only about half of the patients were employed at baseline and this proportion remained stable. Global disability, cognitive sequelae and fatigue had the highest prognostic performance.

KEYWORDS:

• Key terms employment
• fatigue
• predictive research
• sequelae
• work ability

Data availability statement

Data from DRUE are available through The Danish Clinical Quality Program – National Clinical Registries (https://www.rkkp.dk/in-english/) under standard conditions.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by the Danish Ministry of Health; Region Hovedstaden and the Capital Region of Denmark.