Predictors for Return to Work in Subjects with Mild Traumatic Brain Injury

Objective. To predict return to work (RTW) at 12 months for patients who either were sick-listed or were at risk to be sick-listed with persistent postconcussion symptoms (PCS) at six to eight weeks after injury.Method. A prospective cohort study of 151 patients with mild traumatic brain injury (MTBI) admitted consecutively to outpatient clinics at two University Hospitals in Norway. The study was conducted as part of a randomised clinical trial. Injury characteristics were obtained from the medical records. Sick leave data from one year before to one year after MTBI were obtained from the Norwegian Labour and Welfare Service. Self-report questionnaires were used to obtain demographic and symptom profiles.Results. We observed a significant negative association between RTW at 12 months and psychological distress, global functioning, and being sick-listed at two months after MTBI, as well as having been sick-listed the last year before injury.Conclusion. Psychological distress, global functioning postinjury, and the sick leave trajectory of the subjects were negative predictors for RTW. These findings should be taken into consideration when evaluating future vocational rehabilitation models.

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Post-Traumatic Headache After Mild Traumatic Brain Injury In A One-Year Follow Up Study – Risk Factors And Return To Work

10.21203/rs.3.rs-1117390/v1 ◽

2021 ◽

Author(s):

Yvonn Kraemer ◽

Kaisa Mäki ◽

Ivan Marinkovic ◽

Taina Nybo ◽

Harri Isokuortti ◽

...

Keyword(s):

Risk Factors ◽

Traumatic Brain Injury ◽

Emergency Department ◽

Brain Injury ◽

Return To Work ◽

Mild Traumatic Brain Injury ◽

Outpatient Clinic ◽

Post Traumatic ◽

One Year

Abstract Background: Post-traumatic headache (PTH) is a common symptom following mild traumatic brain injury (mTBI). Patients at risk to develop acute PTH (aPTH) and further persistent PTH (pPTH) need to be recognized. Methods: This is a one-year follow-up of 127 patients with mTBI, aged 18 to 68, referred to outpatient clinic in the Helsinki University Hospital. Symptoms were assessed at the emergency department (ED), with structured interview at outpatient clinic visit and with Rivermead post-concussion symptom questionnaire at one, three, and 12 months after injury. Psychiatric disorders were assessed with Structured Clinical Interview for DSM-IV Axis I disorders at 3-4 months and return to work (RTW) from patient records. Results: At one month, 77/127 patients (61%) had aPTH. According to multiple logistic regression analysis, risk factors for aPTH were headache at the emergency department (ED) (OR 5.43), other pain (OR 3.19), insomnia (OR 3.23), and vertigo (OR 5.98). At three months, 17 patients (22% of aPTH patients) had developed pPTH, and at one year, 4 patients (24% of pPTH patients) still presented with pPTH. Risk factors for pPTH at three months were older age (OR 1.06) and current insomnia (OR 12.3). The frequency of psychiatric disorders did not differ between the groups. pPTH patients performed worse on their RTW. Conclusions: Risk factors for aPTH were insomnia, headache at ED, other pain, and vertigo and for pPTH, insomnia and older age. RTW rate was lower among pPTH patients.

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Outcome from Complicated versus Uncomplicated Mild Traumatic Brain Injury

Rehabilitation Research and Practice ◽

10.1155/2012/415740 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 28

Author(s):

Grant L. Iverson ◽

Rael T. Lange ◽

Minna Wäljas ◽

Suvi Liimatainen ◽

Prasun Dastidar ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Return To Work ◽

Mild Traumatic Brain Injury ◽

Self Report ◽

University Hospital ◽

Mri Scan ◽

Significant Difference ◽

Icd 10 ◽

Neurocognitive Measures

Objective. To compare acute outcome following complicated versus uncomplicated mild traumatic brain injury (MTBI) using neurocognitive and self-report measures.Method. Participants were 47 patients who presented to the emergency department of Tampere University Hospital, Finland. All completed MRI scanning, self-report measures, and neurocognitive testing at 3-4 weeks after injury. Participants were classified into the complicated MTBI or uncomplicated MTBI group based on the presence/absence of intracranial abnormality on day-of-injury CT scan or 3-4 week MRI scan.Results. There was a large statistically significant difference in time to return to work between groups. The patients with uncomplicated MTBIs had a median of 6.0 days (IQR = 0.75–14.75, range = 0–77) off work compared to a median of 36 days (IQR = 13.5–53, range = 3–315) for the complicated group. There were no significant differences between groups for any of the neurocognitive or self-report measures. There were no differences in the proportion of patients who (a) met criteria for ICD-10 postconcussional disorder or (b) had multiple low scores on the neurocognitive measures.Conclusion. Patients with complicated MTBIs took considerably longer to return to work. They did not perform more poorly on neurocognitive measures or report more symptoms, at 3-4 weeks after injury compared to patients with uncomplicated MTBIs.

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Pain Catastrophizing Correlates with Early Mild Traumatic Brain Injury Outcome

Pain Research and Management ◽

10.1155/2016/2825856 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Geneviève Chaput ◽

Susanne P. Lajoie ◽

Laura M. Naismith ◽

Gilles Lavigne

Keyword(s):

Traumatic Brain Injury ◽

Chronic Pain ◽

Psychological Distress ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Pain Catastrophizing ◽

Self Report ◽

Pain Severity ◽

Cross Sectional ◽

Postconcussion Symptoms

Background.Identifying which patients are most likely to be at risk of chronic pain and other postconcussion symptoms following mild traumatic brain injury (MTBI) is a difficult clinical challenge.Objectives.To examine the relationship between pain catastrophizing, defined as the exaggerated negative appraisal of a pain experience, and early MTBI outcome.Methods.This cross-sectional design included 58 patients diagnosed with a MTBI. In addition to medical chart review, postconcussion symptoms were assessed by self-report at 1 month (Time 1) and 8 weeks (Time 2) after MTBI. Pain severity, psychological distress, level of functionality, and pain catastrophizing were measured by self-report at Time 2.Results.The pain catastrophizing subscales of rumination, magnification, and helplessness were significantly correlated with pain severity (r=.31to.44), number of postconcussion symptoms reported (r=.35to.45), psychological distress (r=.57to.67), and level of functionality (r=-.43to-.29). Pain catastrophizing scores were significantly higher for patients deemed to be at high risk of postconcussion syndrome (6 or more symptoms reported at both Time 1 and Time 2).Conclusions.Higher levels of pain catastrophizing were related to adverse early MTBI outcomes. The early detection of pain catastrophizing may facilitate goal-oriented interventions to prevent or minimize the development of chronic pain and other postconcussion symptoms.

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