EMPLOYMENT FOLLOWING TRAUMATIC HEAD-INJURIES

Objective: Determine rates of, and factors predictive of, return to wo rk in patients with civilian traumatic head injuries. Design: Inceptio n cohort study with 1- to 2-year follow-up. Setting: Hospitalized pati ents in a level I trauma center. Patients: Three hundred sixty-six hos pitalized head-injured subjects who were workers before injury and 95 comparison subjects participated in prospective, longitudinal investig ations of employment following head injury. Head-injured and compariso n subjects were similar on basic demographics and preinjury employment status. The comparison subjects consisted of patients who sustained t raumatic 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 l eg, education, preinjury work history), the severity of head injury an d associated neuropsychologic problems, and se verity of other system injuries. More precise predictions were possible using the multivariat e 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 s timulate discussions of appropriate use of services and resources to m eet individual patients' needs.