Preinjury employment status as a risk factor for symptomatology and disability in mild traumatic brain injury: A TRACK-TBI analysis.
NeuroRehabilitation
; 43(2): 169-182, 2018.
Article
em En
| MEDLINE
| ID: mdl-30040754
ABSTRACT
BACKGROUND:
Preinjury employment status may contribute to disparity, injury risk, and recovery patterns following mild traumatic brain injury (MTBI).OBJECTIVE:
To characterize associations between preinjury unemployment, prior comorbidities, and outcomes following MTBI.METHODS:
MTBI patients from TRACK-TBI Pilot with complete six-month outcomes were extracted. Preinjury unemployment, comorbidities, injury factors, and intracranial pathology were considered. Multivariable regression was performed for employment and outcomes, correcting for demographic and injury factors. Mean-differences (B) and 95% CIs are reported. Statistical significance was assessed at p < 0.05.RESULTS:
162 MTBI patients were aged 39.8±15.4-years and 24.6% -unemployed. Unemployed patients demonstrated increased psychiatric comorbidities (45.0% -vs.- 23.8%; p = 0.010), drug use (52.5% -vs.- 21.3%; p < 0.001), smoking (62.5% -vs.- 27.0%; p < 0.001), prior TBI (78.4% -vs.- 55.0%; p = 0.012), and lower education (15.0% -vs.- 45.1% college degree; p = 0.003). On multivariable analysis, unemployment associated with decreased six-month functional outcome (Glasgow Outcome Scale-Extended B = - 0.50, 95% CI [- 0.88, - 0.11]), increased psychiatric disturbance (Brief Symptom Inventory-18 B = 6.22 [2.33, 10.10]), postconcussional symptoms (Rivermead Questionnaire B = 4.91 [0.38, 9.44]), and post-traumatic stress disorder (PTSD Checklist-Civilian B = 5.99 [0.76, 11.22]). No differences were observed for cognitive measures or satisfaction with life.CONCLUSIONS:
Unemployed patients are at risk for preinjury psychosocial comorbidities, poorer six-month functional recovery and increased psychiatric/postconcussional/PTSD symptoms. Resource allocation and return precautions should be implemented to mitigate and/or prevent the decline of at-risk patients.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transtornos de Estresse Pós-Traumáticos
/
Concussão Encefálica
/
Emprego
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
NeuroRehabilitation
Assunto da revista:
NEUROLOGIA
/
REABILITACAO
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Estados Unidos