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. 2020 Jun 26;9(6):2007.
doi: 10.3390/jcm9062007.

Early Predictors of Employment Status One Year Post Injury in Individuals with Traumatic Brain Injury in Europe

Juan Carlos Arango-Lasprilla  1   2   3 , Marina Zeldovich  4 , Laiene Olabarrieta-Landa  5 , Marit Vindal Forslund  6 , Silvia Núñez-Fernández  1 , Nicole von Steinbuechel  4 , Emilie Isager Howe  6   7 , Cecilie Røe  6   7   8 , Nada Andelic  6   8 , Center-Tbi Participants And Investigators
Affiliations

Early Predictors of Employment Status One Year Post Injury in Individuals with Traumatic Brain Injury in Europe

Juan Carlos Arango-Lasprilla et al. J Clin Med. .

Abstract

Sustaining a traumatic brain injury (TBI) often affects the individual's ability to work, reducing employment rates post-injury across all severities of TBI. The objective of this multi-country study was to assess the most relevant early predictors of employment status in individuals after TBI at one-year post-injury in European countries. Using a prospective longitudinal non-randomized observational cohort (The Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) project), data was collected between December 2014-2019 from 63 trauma centers in 18 European countries. The 1015 individuals who took part in this study were potential labor market participants, admitted to a hospital and enrolled within 24 h of injury with a clinical TBI diagnosis and indication for a computed tomography (CT) scan, and followed up at one year. Results from a binomial logistic regression showed that older age, status of part-time employment or unemployment at time of injury, premorbid psychiatric problems, and higher injury severity (as measured with higher Injury severity score (ISS), lower Glasgow Coma Scale (GCS), and longer length of stay (LOS) in hospital) were associated with higher unemployment probability at one-year after injury. The study strengthens evidence for age, employment at time of injury, premorbid psychiatric problems, ISS, GCS, and LOS as important predictors for employment status one-year post-TBI across Europe.

Keywords: employment; multicenter studies; outcome assessment; prospective studies; rehabilitation; traumatic brain injury.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Sample flow chart diagram. Abbreviations: N = number (n = number in subgroups); ISS = Injury severity score; GCS = Glasgow Coma Scale; LOC = Loss of consciousness; Length of stay = Length of stay in the hospital.
Figure 2
Figure 2
Employment status changes from baseline (left part) to one-year post TBI (right part). Note that the categorization of employment status at the two timepoints are different. At baseline employed: individuals were in labor market or currently at sick leave split in full-time and part-time groups; and unemployed: individuals were out of labor market. At one-year post TBI, employed individuals returned to work (either with the same amount of hours or with reduced hours, or individuals who changed the work); and unemployed individuals, who are unable to work and individuals looking for work.
Figure 3
Figure 3
Employment rates at the baseline and one year after TBI by TBI severity groups.
Figure 4
Figure 4
Odds ratios for the final model predicting probability of being employed one-year after TBI. Asterisks (*) indicate significant factors or factor levels. Values < 1 represent factors and factor levels with decreased probability of being employed one-year after TBI; values > 1 indicate for a higher probability of employment. Numbers in parentheses are referred to Table 1. The optimism-corrected Nagelkerke’s R² demonstrates the relative information gain of the final model compared to the null model (model without predictors, and intercept only).
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