Employment outcome four years after a severe traumatic brain injury: results of the Paris severe traumatic brain injury study

Disabil Rehabil. 2018 Sep;40(18):2200-2207. doi: 10.1080/09638288.2017.1327992. Epub 2017 May 18.


Objective: To describe employment outcome four years after a severe traumatic brain injury by the assessment of individual patients' preinjury sociodemographic data, injury-related and postinjury factors.

Design: A prospective, multicenter inception cohort of 133 adult patients in the Paris area (France) who had received a severe traumatic brain injury were followed up postinjury at one and four years. Sociodemographic data, factors related to injury severity and one-year functional and cognitive outcomes were prospectively collected.

Methods: The main outcome measure was employment status. Potential predictors of employment status were assessed by univariate and multivariate analysis.

Results: At the four-year follow-up, 38% of patients were in paid employment. The following factors were independent predictors of unemployment: being unemployed or studying before traumatic brain injury, traumatic brain injury severity (i.e., a lower Glasgow Coma Scale score upon admission and a longer stay in intensive care) and a lower one-year Glasgow Outcome Scale-Extended score.

Conclusion: This study confirmed the low rate of long-term employment amongst patients after a severe traumatic brain injury. The results illustrated the multiple determinants of employment outcome and suggested that students who had received a traumatic brain injury were particularly likely to be unemployed, thus we propose that they may require specific support to help them find work. Implications for rehabilitation Traumatic brain injury is a leading cause of persistent disablity and can associate cognitive, emotional, physical and sensory impairments, which often result in quality-of-life reduction and job loss. Predictors of post-traumatic brain injury unemployment and job loss remains unclear in the particular population of severe traumatic brain injury patients. The present study highlights the post-traumatic brain injury student population require a close follow-up and vocational rehabilitation. The study suggests that return to work post-severe traumatic brain injury is frequently unstable and workers often experience difficulties that caregivers have to consider.

Keywords: Traumatic brain injury; disability; employment; follow-up study; return to work.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brain Injuries, Traumatic* / diagnosis
  • Brain Injuries, Traumatic* / epidemiology
  • Brain Injuries, Traumatic* / rehabilitation
  • Cohort Studies
  • Employment / methods
  • Employment / statistics & numerical data
  • Female
  • Glasgow Outcome Scale
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Outcome Assessment, Health Care
  • Paris / epidemiology
  • Prospective Studies
  • Rehabilitation, Vocational / methods
  • Rehabilitation, Vocational / statistics & numerical data
  • Unemployment