Preinjury employment status as a risk factor for symptomatology and disability in mild traumatic brain injury: A TRACK-TBI analysis

Autor:	Maryse C Cnossen, Mary J. Vassar, John K. Yue, Track-Tbi Investigators, Hester F. Lingsma, Catherine G Suen, Molly Rose Morrissey, Sabrina R Taylor, Pratik Mukherjee, Alex B. Valadka, Jonathan Rick, David O. Okonkwo, Tene A. Cage, Esther L. Yuh, Hansen Deng, Raquel C. Gardner, Geoffrey T. Manley
Přispěvatelé:	Public Health
Rok vydání:	2018
Předmět:	Adult Employment Male Intracranial pathology medicine.medical_specialty Adolescent Traumatic brain injury Physical Therapy Sports Therapy and Rehabilitation Stress Disorders Post-Traumatic 03 medical and health sciences 0302 clinical medicine Statistical significance Internal medicine Injury risk Medicine Humans Disabled Persons 030212 general & internal medicine Risk factor Brain Concussion Aged business.industry Rehabilitation Recovery of Function Rivermead post-concussion symptoms questionnaire Middle Aged Functional recovery medicine.disease Female Neurology (clinical) business Psychosocial 030217 neurology & neurosurgery
Zdroj:	NeuroRehabilitation, 43(2), 169-182. IOS Press BV
ISSN:	1878-6448 1053-8135
Popis:	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.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fc6474e273bc84cc70681fe4d09f6f00 https://pubmed.ncbi.nlm.nih.gov/31006696 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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