scholarly journals Sequence analysis of sickness absence and disability pension in the year before and the three years following a bicycle crash; a nationwide longitudinal cohort study of 6353 injured individuals

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Linnea Kjeldgård ◽  
Helena Stigson ◽  
Kristina Alexanderson ◽  
Emilie Friberg
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sequence Analysis ◽  
Sickness Absence ◽  
Disability Pension ◽  
Brain Injuries ◽  
Multinomial Logistic Regression ◽  
Road User ◽  
Full Time

Abstract Background Bicyclists are the road user group with the highest number of severe injuries in the EU, yet little is known about sickness absence (SA) and disability pension (DP) following such injuries. Aims To explore long-term patterns of SA and DP among injured bicyclists, and to identify characteristics associated with the specific patterns. Methods A longitudinal register-based study was conducted, including all 6353 individuals aged 18–59 years and living in Sweden in 2009, who in 2010 had incident in-patient or specialized out-patient healthcare after a bicycle crash. Information about sociodemographic factors, the injury, SA (SA spells > 14 days), and DP was obtained from nationwide registers. Weekly SA/DP states over 1 year before through 3 years after the crash date were used in sequence and cluster analyses. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with each identified sequence cluster. Results Seven clusters were identified: “No SA or DP” (58.2% of the cohort), “Low SA or DP” (7.4%), “Immediate SA” (20.3%), “Episodic SA” (5.9%), “Long-term SA” (1.7%), “Ongoing part-time DP” (1.7%), and “Ongoing full-time DP” (4.8%). Compared to the cluster “No SA or DP”, all other clusters had higher ORs for women, and higher age. All clusters but “Low SA and DP” had higher ORs for inpatient healthcare. The cluster “Immediate SA” had a higher OR for: fractures (OR 4.3; CI 3.5–5.2), dislocation (2.8; 2.0–3.9), sprains and strains (2.0; 1.5–2.7), and internal injuries (3.0; 1.3–6.7) compared with external injuries. The cluster “Episodic SA” had higher ORs for: traumatic brain injury, not concussion (4.2; 1.1–16.1), spine and back (4.5; 2.2–9.5), torso (2.5; 1.4–4.3), upper extremities (2.9; 1.9–4.5), and lower extremities (3.5; 2.2–5.5) compared with injuries to the head, face, and neck (not traumatic brain injuries). The cluster “Long-term SA” had higher ORs for collisions with motor vehicles (1.9;1.1–3.2) and traumatic brain injury, not concussion (18.4;2.2–155.2). Conclusion Sequence analysis enabled exploration of the large heterogeneity of SA and DP following a bicycle crash. More knowledge is needed on how to prevent bicycle crashes and especially those crashes/injuries leading to long-term consequences.

scholarly journals Return to work after first incidence of long-term sickness absence: A 10-year prospective follow-up study identifying labour-market trajectories using sequence analysis

2019 ◽  
Vol 48 (2) ◽  
pp. 134-143 ◽  
Author(s):  
Aleksander Årnes Madsen
Keyword(s):  
Sequence Analysis ◽  
Return To Work ◽  
Labour Market ◽  
Sickness Absence ◽  
Multinomial Logistic Regression ◽  
Full Time ◽  
Occupational Class ◽  
Time Work ◽  
Part Time

Aims: The study aim was to identify prototypical labour-market trajectories following a first incidence of long-term sickness absence (LTSA), and to assess whether baseline socio-demographic characteristics are associated with the return-to-work (RTW) process and labour-market attachment (LMA). Methods: This prospective study used Norwegian administrative registers with quarterly information on labour-market participation to follow all individuals born 1952–1978 who underwent a first LTSA during the first quarter of 2004 ( n =9607) over a 10-year period (2004–2013). Sequence analysis was used to identify prototypical labour-market trajectories and LMA; trajectory membership was examined with multinomial logistic regression. Results: Sequence analysis identified nine labour-market trajectories illustrating the complex RTW process, with multiple states and transitions. Among this sample, 68.2% had a successful return to full-time work, while the remaining trajectories consisted of part-time work, unemployment, recurrence of LTSA, rehabilitation and disability pension (DP). A higher odds ratio (OR) for membership to trajectories of weaker LMA was found for females and older participants, while being married/cohabitating, having children, working in the public sector, and having a higher education, income and occupational class were associated with a lower OR of recurrence, unemployment, rehabilitation and DP trajectories. These results are consistent with three LMA indicators. Conclusions: Sequence analysis revealed prototypical labour-market trajectories and provided a holistic overview of the heterogeneous RTW processes. While the most frequent outcome was successful RTW, several unfavourable labour-market trajectories were identified, with trajectory membership predicted by socio-demographic measures.

scholarly journals Sickness absence and disability pension sequences before and after a bicycle crash; a Swedish study

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Kjeldgård ◽  
H Stigson ◽  
K Alexanderson ◽  
E Friberg
Keyword(s):  
Sickness Absence ◽  
Disability Pension ◽  
Brain Injuries ◽  
Multinomial Logistic Regression ◽  
Body Region ◽  
Full Time ◽  
Direct Connection ◽  
Before And After ◽  
Part Time ◽  
Type Of Injury

Abstract Background In recent years, bicycle injuries have increased, yet little is known about impact of such injures on sickness absence (SA) and disability pension (DP). The aim was to explore the long-term patterns of SA and DP among injured bicyclists. Methods A longitudinal register-based study was conducted, including all individuals aged 18-59 years and living in Sweden, who in 2010 had incident in- or specialized out-patient healthcare for injuries sustained in a bicycle crash. Information about sociodemographics, the injury, SA, DP, and deaths were obtained from several nationwide registers. Weekly SA/DP data for four years: one year before and three years after the crash were used in sequence and cluster analyses. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with each sequence cluster. Results Among all 6465 individuals injured in a bicycle crash 2010, five clusters were identified: No SA or DP (60.2%), Immediate SA (17.7%), Episodic SA (15.3%), Part-time DP (1.6%), and Full-time DP (5.2%). Compared to the cluster No SA or DP, all other clusters had high ORs for female sex, older age, living in small cities/villages, and inpatient care. Immediate SA also had high ORs for cyclists who sustained a fracture (OR 5.53; CI 4.47-6.83), dislocation (3.26; 2.29-4.65), sprains and strains (2.29; 1.68-3.10), and internal injuries (4.39; 1.95-9.90). Episodic SA had high ORs for other traumatic brain injury than concussion (6.27; 2.23-17.64) and injuries located in the spine and back (3.52; 2.12-5.86), torso (1.78; 1.29-2.45), upper extremities (1.95; 1.54-2.46), and lower extremities (1.85; 1.43-2.41). Conclusions Having SA in direct connection to the crash was associated with type of injury, in contrast to Episodic SA where the injured body region was of more importance, in particular other traumatic brain injuries and injuries to the spine and back. Key messages This nationwide study of new bicycle crashes found five clusters of sickness absence (SA) and disability pension (DP) sequences; No SA or DP, Immediate SA, Episodic SA, Part-time DP, and Full-time DP. The type of injury was more important for SA in direct connection to the crash, while the injured body region was of more importance for continued and repeated SA up to three years after the crash.

Long-term Quality of Life After Decompressive Craniectomy in Severe Traumatic Brain Injury and Stroke

2021 ◽  
Author(s):  
Alex Vicino ◽  
Philippe Vuadens ◽  
Bertrand Léger ◽  
Charles Benaim
Keyword(s):  
Quality Of Life ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Acute Phase ◽  
Decompressive Craniectomy ◽  
Severe Traumatic Brain Injury ◽  
Full Time ◽  
Stroke Patients

Abstract PurposeDecompressive craniectomy (DC) can rapidly reduce intracranial pressure and save lives in the acute phase of severe traumatic brain injury (TBI) or stroke, but little is known about the long-term outcome after DC. We evaluated quality of life (QoL) a few years after DC for severe TBI/stroke.MethodsThe following data were collected for stroke/TBI patients hospitalized for neurorehabilitation after DC: 1) at discharge, motor and cognitive sub-scores of the Functional Independence Measure (motor-FIM [score 13-91] and cognitive-FIM [score 5-35]) and 2) more than 4 years after discharge, the QOLIBRI health-related QoL (HR-QoL) score (0-100; <60 representing low or impaired QoL) and the return to work (RTW: 0%, partial, 100%)ResultsWe included 88 patients (66 males, median age 38 [interquartile range 26.3-51.0], 65 with TBI/23 stroke); 46 responded to the HR-QoL questionnaire. Responders and non-responders had similar characteristics (age, sex, functional levels upon discharge). Median motor-FIM and cognitive-FIM scores were 85/91 and 27/35, with no significant difference between TBI and stroke patients. Long-term QoL was borderline low for TBI patients and within normal values for stroke patients (score 58.0[42.0-69.0] vs. 67.0[54.0-81.5], p=0.052). RTW was comparable between the groups (62% full time).ConclusionWe already knew that DC can save the lives of TBI or stroke patients in the acute phase and this study suggests that their long-term quality of life is generally quite acceptable.

scholarly journals Traumatic Brain Injury and Delayed Sequelae: A Review - Traumatic Brain Injury and Mild Traumatic Brain Injury (Concussion) are Precursors to Later-Onset Brain Disorders, Including Early-Onset Dementia

2007 ◽  
Vol 7 ◽  
pp. 1768-1776 ◽  
Author(s):  
Michael A. Kiraly ◽  
Stephen J. Kiraly
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Brain Injuries ◽  
Brain Disorders ◽  
Early Onset Dementia ◽  
Human Experiments ◽  
Delayed Consequences ◽  
Subsequent Onset

Brain injuries are too common. Most people are unaware of the incidence of and horrendous consequences of traumatic brain injury (TBI) and mild traumatic brain injury (MTBI). Research and the advent of sophisticated imaging have led to progression in the understanding of brain pathophysiology following TBI. Seminal evidence from animal and human experiments demonstrate links between TBI and the subsequent onset of premature, psychiatric syndromes and neurodegenerative diseases, including Alzheimer's disease (AD) and Parkinson's disease (PD). Objectives of this summary are, therefore, to instill appreciation regarding the importance of brain injury prevention, diagnosis, and treatment, and to increase awareness regarding the long-term delayed consequences following TBI.

scholarly journals Traumatic Brain Injury in Sports: A Review

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Christopher S. Sahler ◽  
Brian D. Greenwald
Keyword(s):  
United States ◽  
Traumatic Brain Injury ◽  
Cognitive Impairment ◽  
Brain Injury ◽  
Head Trauma ◽  
Brain Injuries ◽  
Cognitive Impairments ◽  
The United States ◽  
Neurological Dysfunction

Traumatic brain injury (TBI) is a clinical diagnosis of neurological dysfunction following head trauma, typically presenting with acute symptoms of some degree of cognitive impairment. There are an estimated 1.7 to 3.8 million TBIs each year in the United States, approximately 10 percent of which are due to sports and recreational activities. Most brain injuries are self-limited with symptom resolution within one week, however, a growing amount of data is now establishing significant sequelae from even minor impacts such as headaches, prolonged cognitive impairments, or even death. Appropriate diagnosis and treatment according to standardized guidelines are crucial when treating athletes who may be subjected to future head trauma, possibly increasing their likelihood of long-term impairments.

scholarly journals Basic special needs and related approaches – mainly medical – for patients following moderate/severe traumatic brain injury

2015 ◽  
Vol 10 (2) ◽  
pp. 107-110
Author(s):  
Cristina POPESCU ◽  
◽  
Aurelian ANGHELESCU ◽  
Cristina DAIA ◽  
Gelu ONOSE ◽  
...  
Keyword(s):  
Health Care ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Special Needs ◽  
Brain Injuries ◽  
Life Time ◽  
Health Care Team ◽  
Interdisciplinary Teams ◽  
Hospital Units

Traumatic brain injury (TBI) may affect almost every aspect of a person’s life. The relationships with family and friends, their roles and responsibilities, all, will require an adjustment period, preferably to be achieved one step at a time, with training and guidance of a specialized health care team. Consequently, such neurologically severe impaired patients have almost always including long term needs, which are quasi-permanent or permanent so endured for a life time. The only way these special needs can be fulfilled or – at best made unnecessary – is the discovery of the way to cure the central nervous system lesions. Because medicine is unfortunately not there yet, this article will review the respective specific numerous long-term needs that may be met by the tools medicine has to offer today, aiming to improve health care in hospital units with rehabilitation profile and to provide ongoing guideline constructs for patients with TBI and their families, after discharge too, aiming at an as complete as possible family social and professional reintegration. Post TBI evolution is influenced by a variety of factors making patients with brain injuries care a complicated and sustained process, the improvements being undoubtedly influenced by their multimodal way to be approached within interdisciplinary teams, applying individualized rehabilitation programs – all in purpose to reach a quasi-normal life or as close to its sense.

scholarly journals Advanced brain injury Neuroprotection therapy

2016 ◽  
Vol 3 (2) ◽  
pp. 1-5
Author(s):  
Sathik R T ◽  
Thanish K
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hyperbaric Oxygen ◽  
Oxygen Therapy ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Current Data ◽  
Long Term Effects ◽  
The People

Head injury typically talks about to TBI, but is a larger category because it can includeinjury to assemblies other than the intelligence, such as the scalp and skull. Traumatic brain injury (TBI) disturbs a rising portion of the people and endures to take national attention with early payment in imaging equipment and in debt of long-term effects. TBI is a most important cause of death and failure to wide-reaching, specifically in teen-agers and undeveloped adults. Males withstand traumatic brain injuries additional habitually than do females. Though, there is great variance in TBI handlingprocedures due to injury inconsistency and absence of both automatousconsiderate and robust treatment references. In Recent years proposes three differenthandlingmethods, all which key purpose at cheering neuroprotection after that TBI, show possibilities: instantaneous hypothermia, hyperbaric oxygen, and progesterone enhancement. The investigation is provocative at times, yet there are profuseopenings to develop the knowledgebehind schedule hypothermia and hyperbaric oxygen therapy which would confidently aid in make straight the current data. Additionally, while progesterone has already been packaged in nanoparticle form it may benefit from continued formulation and managementinvestigation. The treatments and the opportunities for development isgo through in the present paper.

scholarly journals Long-Term Quality of Life after Decompressive Craniectomy in Severe Traumatic Brain Injury and Stroke

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Vicino A ◽  
◽  
Vuadens P ◽  
Léger B ◽  
Benaim C ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Acute Phase ◽  
Decompressive Craniectomy ◽  
Severe Traumatic Brain Injury ◽  
Full Time ◽  
Stroke Patients

Purpose: Decompressive Craniectomy (DC) can rapidly reduce intracranial pressure and save lives in the acute phase of severe Traumatic Brain Injury (TBI) or stroke, but little is known about the long-term outcome after DC. We evaluated Quality of Life (QoL) a few years after DC for severe TBI/stroke. Methods: The following data were collected for stroke/TBI patients hospitalized for neurorehabilitation after DC: 1) at discharge, motor and cognitive sub-scores of the Functional Independence Measure (motor-FIM (score 13-91) and cognitive-FIM (score 5-35)) and 2) more than 4 years after discharge, the QOLIBRI health-related QoL (HR-QoL) score (0-100; <60 representing low or impaired QoL) and the return to work (RTW: 0%, partial, 100%). Results: We included 88 patients (66 males, median age 38 (interquartile range 26.3-51.0), 65 with TBI/23 stroke); 46 responded to the HR-QoL questionnaire. Responders and non-responders had similar characteristics (age, sex, functional levels upon discharge). Median motor-FIM and cognitive- FIM scores were 85/91 and 27/35, with no significant difference between TBI and stroke patients. Long-term QoL was borderline low for TBI patients and within normal values for stroke patients (score 58.0 (42.0-69.0) vs. 67.0 (54.0- 81.5), p=0.052). RTW was comparable between the groups (62% full time). Conclusion: We already knew that DC can save the lives of TBI or stroke patients in the acute phase and this study suggests that their long-term quality of life is generally quite acceptable.

scholarly journals VITAMIN-ANTIOXIDANT HOMEOSTASIS DATA IN PATIENTS WITH LONG-TERM CONSEQUENCES AFTER MILD TRAUMATIC BRAIN INJURY

2020 ◽  
Vol 46 (3) ◽  
pp. 15
Author(s):  
Y. V. Lekomtseva
Keyword(s):  
Traumatic Brain Injury ◽  
Vitamin E ◽  
Brain Injury ◽  
Vitamin C ◽  
Mild Traumatic Brain Injury ◽  
Brain Injuries ◽  
Serum Vitamin ◽  
Secondary Brain Injury ◽  
Long Term Consequences

Introduction. Mild traumatic brain injury (mTBI) was reported to be the most frequent among other types of brain injuries and is the main reason for the disability in mid-life and middleaged people. It’s known that antioxidants can reduce oxidative stress, so, to prevent secondary brain injury modulating maintaining of long-term consequences after mTBI. Purpose of the study. This work was to study the serum vitamin E, C and A levels in the patients with long-term consequences after mTBI to explore their potential pathogenetic influence. Materials and methods. Sixty-seven patients with long-term consequences after mTBI were investigated with the mean age of 43,61 ± 8,24 years (18 women, 26,86% and 49 men, 73,14%) where the vitamin E, C and A contents were measured in sera by spectrophotometer method using standard protocols and reagents (Sigma, USA).  Results. In this work, it was found descending serum levels of all investigated vitaminantioxidants in almost all patients with longterm consequences after mTBI where the content of vitamins A (M ± s: 1,63 ± 1,56 mkM/l) and E (25,41 ± 0,93 mkM/l) had a tendency to decreasing without significant differences compare to controls. It was found the statistically significant decreased of vitamin C levels in the serum samples of our investigated patients when compared to controls (p < 0,05, t = 4,59, 95% CI 98,81 to 55,68) where in the main patient group, the medians of total vitamin C level was 30,57 ± 5,38 mkM/l vs 36,91 ± 5,22 mkM/l in controls. It was shown that the patients with long-term consequences after mild contusion in anamnesis (64,18%) had the prominent changes in the vitamin C content. Conclusion. The maintaining of long-term consequences of mTBI was accompanied by the vitamin-antioxidant dyshomeostasis such as decreasing of vitamin C serum level associated with a tendency to decreasing of vitamins A and E levels that may play the certain role in the pathogenesis. All these data are needed to be accounted into the consideration during the treatment of this patient category. Keywords: long-term consequences of mild traumatic brain injury, vitamin-antioxidant homeostasis.

scholarly journals Doctrine of head injury sequelae

2019 ◽  
Vol 21 (1) ◽  
pp. 83-89 ◽  
Author(s):  
L. B. Likhterman
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Brain Injuries ◽  
Skull Defects ◽  
Post Traumatic ◽  
Carotid Cavernous Fistulas ◽  
Radiological Grading ◽  
Diffuse Brain

In this article, we provide the definitions of “sequelae” and “complications” of traumatic brain injury (TBI). We have developed the classification principles for TBI consequences and described their clinical forms and morphological substrates. We also provide a radiological grading for assessing the severity of sequelae of focal and diffuse brain injuries. The article covers conceptual approaches, technologies, and results of their application related to leading surgically significant consequences of TBI, including carotid cavernous fistulas, chronic subdural hematomas, post-traumatic hydrocephalus, long-term basal liquorrhea, and skull defects. We have developed the doctrine of sequelae of TBI.

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