February 1994

Employment Following Traumatic Head Injuries

Author Affiliations

From the Departments of Rehabilitation Medicine (Drs Dikmen and Fraser and Ms Machamer), Neurological Surgery (Drs Temkin, Fraser, Dikmen, and Winn and Ms Holubkov), Psychiatry and Behavioral Sciences (Dr Dikmen), and Biostatistics (Dr Temkin), University of Washington, Seattle.

Arch Neurol. 1994;51(2):177-186. doi:10.1001/archneur.1994.00540140087018

Objective:  Determine rates of, and factors predictive of, return to work in patients with civilian traumatic head injuries.

Design:  Inception cohort study with 1- to 2-year follow-up.

Setting:  Hospitalized patients in a level I trauma center.

Patients:  Three hundred sixty-six hospitalized head-injured subjects who were workers before injury and 95 comparison subjects participated in prospective, longitudinal investigations of employment following head injury. Head-injured and comparison subjects were similar on basic demographics and preinjury employment status. The comparison subjects consisted of patients who sustained traumatic injury to the body but not to the head.

Main Outcome Measure:  Time taken to return to work following head injury.

Results:  Survival methodology was used for analysis. Whether patients returned to work and when related to both the characteristics of the injured patients (eg, education, preinjury work history), the severity of head injury and associated neuropsychologic problems, and severity of other system injuries. More precise predictions were possible using the multivariate model.

Conclusions:  The present study provides a means of assessing employment potential predictively. This can be useful for clinical and research purposes. The results should be used cautiously and should stimulate discussions of appropriate use of services and resources to meet individual patients' needs.