Return to productive activity after traumatic brain injury: relationship with measures of disability, handicap, and community integration.

Abstract

To identify which factors are associated with successful return to productive activity (RTPA) 1 year after hospitalization with traumatic brain injury (TBI) and to examine the relations between successful RTPA and other measures of impairment, disability, handicap, and integration into the community. Prospective study with 1-year follow-up. Level I trauma center. One hundred five respondents from a cohort of 378 adults hospitalized with TBI admitted between September 1997 and May 1998. Not applicable. Return to productive work 1 year after injury; Disability Rating Scale (DRS); and Community Integration Scale (CIQ). Of the 105 participants, 72% achieved RTPA. Logistic regression showed an association between RPTA and the following factors: premorbid educational level, premorbid psychiatric history, violent mechanism of injury, discharge status after acute hospitalization, prior alcohol and drug use, and injury severity. Handicap and community integration at 1-year postinjury, as measured by subscales of the DRS and the CIQ, were also associated with RTPA. Premorbid and injury-related variables and measures of handicap and community integration were associated with RTPA at 1 year. To understand and effectively support vocational pursuits in the TBI population, future studies are needed to define further causality and origin of these relationships.