Predictors of global functioning and employment 10 years following traumatic brain injury compared with orthopaedic injury

Abstract

Objective: The aim of this study was to prospectively investigate predictors of global functioning and employment 10 years following traumatic brain injury (TBI) compared with orthopaedic trauma.

Research design: Prospective cohort.

Methods: Ninety-seven individuals with complicated mild-to-severe TBI and 91 with traumatic orthopaedic injury were followed-up at 10 years post-injury. Global functioning (GOS-E) and employment status were recorded.

Results: Groups did not differ on global functioning or employment status. Post-TBI, shorter PTA and less severe orthopaedic injuries were associated with better global functioning; and shorter PTA and younger age were associated with employment. Following traumatic orthopaedic injury, younger age was associated with employment, but not after excluding individuals no longer in the labour force.

Conclusions: In this sample, demographic factors and injury severity contribute to long-term outcomes following TBI, but not orthopaedic trauma. PTA continues to influence outcomes 10 years following TBI. There is ongoing detrimental influence of orthopaedic injuries on global functioning for individuals with TBI, suggesting a potential benefit in greater clinical attention to these injuries. Further understanding of the complex interplay between these predictors and other personal and environmental factors will contribute to improving individualized rehabilitation.

• Traumatic brain injury
• employment
• global functioning
• prediction
• orthopaedic trauma

Acknowledgements

Information for individuals with traumatic brain injury was accessed from data collected for the Longitudinal Head Injury Study funded by the Transport Accident Commission (TAC), through the Institute for Safety, Compensation and Recovery Research (ISCRR). The authors acknowledge the contribution of Bridget Hill, who calculated ISS and Bethesda scores for all participants.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.