TOPLINE:

Traumatic brain injury (TBI) was associated with a persistently increased risk for work disability across all severity groups, and this risk was influenced by sociodemographic and medical factors, a new cohort analysis showed.

METHODOLOGY:

• A population-based cohort study used data from Swedish national registers for more than 98,000 adult patients with TBI between 2005 and 2016 and more than 981,000 matched individuals without TBI.
• Patients were placed into one of three groups on the basis of TBI severity: the mild TBI A group (93%) had 2 or less days of hospital stay and no neurosurgery (median age, 38 years; 57% men); the moderate TBI B group (6%) had 3 or more days of hospital stay and no neurosurgery (median age, 48 years; 67.5% men); and the TBI C group (< 1%) had severe trauma requiring neurosurgery (median age, 45 years; 72% men).
• The primary outcome was transition probability to or from work disability, defined as more than 14 days of sickness absence and/or disability pension during 5 years of follow-up.

TAKEAWAY:

• At 5 years, probabilities for transition to work disability were consistently higher across all TBI groups (TBI A, 7% of the group; TBI B, 11%; TBI C, 13%) compared to the non-TBI control group (4%). The TBI C group had the lowest probability of recovery from work disability.
• In the TBI A and B groups, predictors of transitioning to work disability included older age (hazard ratios [HRs], 1.23 and 1.34, respectively), being a woman (HRs, 1.59 and 1.35), and having a psychiatric disorder (HRs, 1.34 and 1.28).
• Higher education in mild cases (HR, 0.83) and having a city residence in both mild and moderate cases (HRs, 0.92 and 0.88) were associated with protective effects.
• In severe cases, only older age was a significant predictor of an increased risk for work disability (HR, 1.59).

IN PRACTICE:

“Our study found no matter the severity, traumatic brain injury was associated with a higher likelihood of a person qualifying for work disability,” lead investigator Andrea Klang, MD, Uppsala University, Uppsala, Sweden, said in a press release.

“Our findings [also] emphasize a need to offer long-term, individualized rehabilitation to all people with traumatic brain injuries to address any impairment,” Klang added.

SOURCE:

This study was published online on February 11 in Neurology.

LIMITATIONS:

The lack of standardized severity grading limited comparison with other studies, and there was a substantial imbalance in group sizes. Additionally, although length of hospital stay was used as a proxy for TBI severity, this measure could also reflect comorbidities, resource availability, and local practices. 

DISCLOSURES:

The study was funded in part by the Swedish Research Council. Klang reported receiving grants from the Swedish state. The other investigators reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.