Function after Motor Vehicle Accidents: A Prospective Study of Mild Head Injury and Posttraumatic Stress

Friedland, Judith; Dawson, Deirdre R.

doi:10.1097/00005053-200107000-00003

Cited by 70 publications

(49 citation statements)

References 38 publications

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“…Rates of RTW range from 42%-69% at 9 to 12 months post-RTC for more serious injuries [7][8][9][10] and from 83% to 100% at 8 to 12 months post-RTC for less serious injuries [10][11][12][13] . The majority of individuals with minor injuries will RTW within 12 months, however there is a substantial minority who will experience delayed or NRTW.…”

Section: Predictors Of Non-return To Work 2 Years Post-injury In Roadmentioning

confidence: 99%

Predictors of non-return to work 2 years post-injury in road traffic crash survivors: Results from the UQ SuPPORT study

Heron-Delaney

Warren

Kenardy

2017

Injury

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Non-return to work following road traffic crash 2 Abstract Purpose: Individuals who have sustained an injury from a road traffic crash (RTC) are at increased risk for long lasting health problems and non-return to work (NRTW). Determining the predictors of NRTW is necessary to develop screening tools to identify at-risk individuals and to provide early targeted intervention for successful return to work (RTW). The aim of this study was to identify factors that can predict which individuals will not RTW following minor or moderate injuries sustained from a RTC.Method: Participants were 194 claimants (63.4% female) within a common-law "fault-based" system from the UQ SuPPORT cohort who were working prior to their RTC. Participants were assessed at 6 months on a variety of physical and mental health measures and RTW status was determined at 2 years post-RTC. RTW rate was 78.4%.Results: Univariate predictors of NRTW included being the driver or passenger, having a prior psychiatric diagnosis, high disability level, low mental or physical quality of life, predicted non-recovery, high pain, low function, high expectations of pain persistency, low expectations about RTW, having a psychiatric diagnosis, elevated depression or anxiety. The final multivariable logistic regression model included only two variables: disability level and expectations about RTW. Seventy-five percent of individuals who will not RTW by 2 years can be identified accurately at an early stage, using only these two predictors. Conclusion:The results are promising, because they suggest that having information about two factors, which are easily obtainable, can predict with accuracy those who will require additional support to facilitate RTW. Keywords: Motor Vehicles; Traffic Accidents; Return to Work; Mental Health; HealthNon-return to work following road traffic crash 3 Predictors of non-return to work 2 years post-injury in road traffic crash survivors: results from the UQ SuPPORT studyThe annual cost of road traffic crashes (RTCs) in Australia is estimated at $27 billion 1 and Australia reports spending 3.6% of its gross domestic product on RTCs 2 . The World Health Organization 3 anticipates that RTC injuries will be the third leading cause of disabilityadjusted life years lost (DALYs) by 2020. One of the major factors contributing to these costs is non-return to work (NRTW) following injury. NRTW is also problematic because working is associated with better health, self-esteem and social connectedness 4,5 , as well as improved quality of life and overall longevity 6 .Previous research on return to work (RTW) rates and predictors in RTC cohorts have produced varied results, most likely due to the differences in the nature of injuries in the samples assessed, the variance in severity of injury (mild through to catastrophic), the timeframe for follow-up, the compensation scheme and other sociocultural factors that vary across countries, such as the health care system. Rates of RTW range from 42%-69% at 9 to 12 months post-RTC for more serious inju...

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Section: Predictors Of Non-return To Work 2 Years Post-injury In Roadmentioning

confidence: 99%

Predictors of non-return to work 2 years post-injury in road traffic crash survivors: Results from the UQ SuPPORT study

Heron-Delaney

Warren

Kenardy

2017

Injury

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“…These findings suggest that mTBI might increase the likelihood of developing PTSD in service members. There has been extensive debate in the literature regarding whether mTBI has a strong effect on the development of PTSD in civilian populations [18][19][20][21][22][23][24][25][26][27][28]. So far, the published data investigating the incidence of PTSD after mTBI in civilian populations are difficult to interpret due to variations in the methodology and conflicting results.…”

Section: Introductionmentioning

confidence: 99%

The Development of Posttraumatic Stress Disorder after Mild Traumatic Brain Injury in Civilian Populations: A Meta-Analysis

Han¹

2014

J Sleep Disorders Ther

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Background: Posttraumatic stress disorder (PTSD) is an anxiety disorder following exposure to a traumatic event. Recent studies demonstrate that mild traumatic brain injury (mTBI) is strongly associated with PTSD among soldiers returning from Iraq. However, the effect of mTBI on development of PTSD in civilian populations is quite controversial. The study is aimed at identifying whether mTBI contributes to an increased risk of PTSD in civilian populations as it happens in the service members.

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“…Relative to non-mTBI survivors, mTBI survivors experience significantly more subjective physical, emotional, and cognitive symptoms, possibly associated with brain changes caused by mTBI. [2][3][4][5][6] Although most symptoms resolve spontaneously in the majority of survivors 3 to 6 months after a single mTBI, about 5% of survivors continue having some symptoms years after trauma, suggesting sustained changes in brain structure or function in these chronic mTBI survivors. 7,8 In addition, those who experience mTBIs repeatedly over their lifetime may develop a progressive neurodegenerative condition known as chronic traumatic encephalopathy.…”

mentioning

confidence: 99%

Early Cortical Thickness Change after Mild Traumatic Brain Injury following Motor Vehicle Collision

Wang

Xie

Cotton

et al. 2015

Journal of Neurotrauma

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In a motor vehicle collision (MVC), survivors often receive mild traumatic brain injuries (mTBI). Although there have been some reports of early white matter changes after an mTBI, much less is known about early cortical structural changes. To investigate early cortical changes within a few days after an MVC, we compared cortical thickness of mTBI survivors with nonmTBI survivors, then reexamined cortical thickness in the same survivors 3 months later. MVC survivors were categorized as mTBI or non-mTBI based on concussive symptoms documented in emergency departments (EDs). Cortical thickness was measured from MRI images using FreeSurfer within a few days and again at 3 months after MVC. Post-traumatic stress symptoms and physical conditions were also assessed. Compared with the non-mTBI group (n = 23), the mTBI group (n = 21) had thicker cortex in the left rostral middle frontal (rMFG) and right precuneus gyri, but thinner cortex in the left posterior middle temporal gyrus at 7.2 -3.1 days after MVC. After 3 months, cortical thickness had decreased in left rMFG in the mTBI group but not in the non-mTBI group. The cortical thickness of the right precuneus region in the initial scans was positively correlated with acute traumatic stress symptoms for all survivors and with the number of reduced activity days for mTBI survivors who completed the follow-up. The preliminary results suggest that alterations in cortical thickness may occur at an early stage of mTBI and that frontal cortex structure may change dynamically over the initial 3 months after mTBI.

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Function after Motor Vehicle Accidents: A Prospective Study of Mild Head Injury and Posttraumatic Stress

Cited by 70 publications

References 38 publications

Predictors of non-return to work 2 years post-injury in road traffic crash survivors: Results from the UQ SuPPORT study

Predictors of non-return to work 2 years post-injury in road traffic crash survivors: Results from the UQ SuPPORT study

The Development of Posttraumatic Stress Disorder after Mild Traumatic Brain Injury in Civilian Populations: A Meta-Analysis

Early Cortical Thickness Change after Mild Traumatic Brain Injury following Motor Vehicle Collision

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