Indicators of long-term return to work after severe traumatic brain injury: A cohort study / V. Wang in Annals of physical and rehabilitation medicine, Vol. 62, n°1 (Janvier 2019)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 28-34 Titre : Indicators of long-term return to work after severe traumatic brain injury: A cohort study Type de document : texte imprimé Auteurs : V. Wang ; E. Fort ; M. Beaudoin-Gobert ; et al. Année de publication : 2019 Article en page(s) : p. 28-34 Note générale : Doi : 10.1016/j.rehab.2018.08.003 Langues : Anglais (eng) Mots-clés : Return to work  Traumatic brain injury  Occupational outcome  Job stability  Vocational rehabilitation Résumé : Background Return to work (RTW) is a major objective in the rehabilitation of individuals with severe traumatic brain injury (TBI). Implications for long-term occupational integration (beyond 5 years) have rarely been studied. Objective The objective was to assess long-term RTW and the associated factors after severe TBI. Material and methods Retrospective analysis of a cohort of individuals 16 to 60 years old admitted to hospital after severe TBI from 2005 to 2009 and followed prospectively. Medical and occupational data were collected from medical files and by systematic telephone interview to assess outcome at a minimum of 6 years post-trauma. Factors associated with RTW were investigated by multivariable regression analysis, estimating prevalence ratios (PRs) and 95% confidence intervals (CIs). A proportional hazards model was used to study RTW delay, estimating hazard ratios (HRs). Results Among the 91 individuals included (mean [SD] age 28.5 [11.3] years; 79% male), 63.7% returned to work after a mean of about 20 months, and 57.1% were still working at the time of the survey. Factors significantly associated with RTW on multivariable analysis were higher educational level (adjusted PR, 1.53; 95% CI, 1.15 to 2.03), absence of motor disability (adjusted PR, 1.82; 1.12 to 2.95) and behavioural disorder (adjusted PR, 1.26; 1.01 to 1.60), as well as disabled worker status (adjusted PR, 1.26; 1.01 to 1.60) (likelihood of the multivariate analysis model 53.1). Delayed RTW was associated with health insurance payments (adjusted HR, 0.40; 95% CI, 0.22 to 0.71), motor disability (adjusted HR, 0.34; 0.15 to 0.76), low educational level (adjusted HR, 2.20; 1.06 to 4.56) and moderate disability on the Extended Glasgow Outcome Scale (adjusted HR, 0.49; 0.27 to 0.91) (likelihood of the multivariate analysis model 335.5). Conclusion Individuals with the most severe TBI are able to RTW and remain in work. This study highlights the multiple determinants involved in RTW and the role of socioenvironmental factors. Permalink : ./index.php?lvl=notice_display&id=82636 [article] Indicators of long-term return to work after severe traumatic brain injury: A cohort study [texte imprimé] / V. Wang ; E. Fort ; M. Beaudoin-Gobert ; et al. . - 2019 . - p. 28-34. Doi : 10.1016/j.rehab.2018.08.003 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 28-34 Mots-clés : Return to work  Traumatic brain injury  Occupational outcome  Job stability  Vocational rehabilitation Résumé : Background Return to work (RTW) is a major objective in the rehabilitation of individuals with severe traumatic brain injury (TBI). Implications for long-term occupational integration (beyond 5 years) have rarely been studied. Objective The objective was to assess long-term RTW and the associated factors after severe TBI. Material and methods Retrospective analysis of a cohort of individuals 16 to 60 years old admitted to hospital after severe TBI from 2005 to 2009 and followed prospectively. Medical and occupational data were collected from medical files and by systematic telephone interview to assess outcome at a minimum of 6 years post-trauma. Factors associated with RTW were investigated by multivariable regression analysis, estimating prevalence ratios (PRs) and 95% confidence intervals (CIs). A proportional hazards model was used to study RTW delay, estimating hazard ratios (HRs). Results Among the 91 individuals included (mean [SD] age 28.5 [11.3] years; 79% male), 63.7% returned to work after a mean of about 20 months, and 57.1% were still working at the time of the survey. Factors significantly associated with RTW on multivariable analysis were higher educational level (adjusted PR, 1.53; 95% CI, 1.15 to 2.03), absence of motor disability (adjusted PR, 1.82; 1.12 to 2.95) and behavioural disorder (adjusted PR, 1.26; 1.01 to 1.60), as well as disabled worker status (adjusted PR, 1.26; 1.01 to 1.60) (likelihood of the multivariate analysis model 53.1). Delayed RTW was associated with health insurance payments (adjusted HR, 0.40; 95% CI, 0.22 to 0.71), motor disability (adjusted HR, 0.34; 0.15 to 0.76), low educational level (adjusted HR, 2.20; 1.06 to 4.56) and moderate disability on the Extended Glasgow Outcome Scale (adjusted HR, 0.49; 0.27 to 0.91) (likelihood of the multivariate analysis model 335.5). Conclusion Individuals with the most severe TBI are able to RTW and remain in work. This study highlights the multiple determinants involved in RTW and the role of socioenvironmental factors. Permalink : ./index.php?lvl=notice_display&id=82636

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