Traumatic brain injury hospitalizations in Belgium: A brief overview of incidence, population characteristics, and outcomes.

Background: There is a need for complete and accurate epidemiological studies for traumatic brain injury (TBI). Secondary use of administrative data can provide country-specific population data across the full spectrum of disease. Aim: This study aims to provide a population-based overview of Belgian TBI hospital admissions as well as their health-related and employment outcomes. Methods: A combined administrative dataset with deterministic linkage at individual level was used to assess all TBI hospitalizations in Belgium during the year 2016. Discharge data were used for patient selection and description of injuries. Claims data represented the health services used by the patient and health-related follow-up beyond hospitalization. Finally, social security data gave insight in changes to employment situation. Results: A total of 17,086 patients with TBI were identified, with falls as the predominant cause of injury. Diffuse intracranial injury was the most common type of TBI and 53% had injuries to other body regions as well. In-hospital mortality was 6%. The median length of hospital stay was 2 days, with 20% being admitted to intensive care and 28% undergoing surgery. After hospitalization, 23% had inpatient rehabilitation. Among adults in the labor force pre-injury, 72% of patients with mild TBI and 59% with moderate-to-severe TBI returned to work within 1 year post-injury. Discussion: Administrative data are a valuable resource for population research. Some limitations need to be considered, however, which can in part be overcome by enrichment of administrative datasets with other data sources such as from trauma registries.

Predictors of return to work after moderate-to-severe traumatic brain injury: a systematic review of current literature and recommendations for future research.

PURPOSE: To identify factors associated with employment between six months and five years after traumatic brain injury (TBI). METHODS: Using a predefined search algorithm, four electronic databases were searched for literature published between 2014 and the first half of April 2021 containing predictors of employment outcome. Data were selected in accordance with the PRISMA flow and the whole process was conducted by two reviewers who had to attain a consensus. The study results were discussed with an expert panel, in order to provide guidance for future research on this topic. RESULTS: This review found clear evidence for employment status at time of injury, occupation at time of injury, Glasgow Coma Scale, length of stay, disability level and primary payer to be predictors of return to work after TBI. CONCLUSIONS: More literature investigating in depth the functioning and environmental factors is required for further improvement of predictions, rehabilitation and policy.Implications for rehabilitationThis study identifies predictors of return to work in TBI patients, which can be used to identify patients with high risk early in the recovery process.Current literature shows difficulties with general functioning are a barrier for return to work, but gives no indication about effective therapeutic interventions.More knowledge about modifiable factors is desirable to improve rehabilitation and, thereby, employment outcomes after TBI.