Long-Term Return to Work After Acquired Brain Injury in Young Danish Adults: A Nation-Wide Registry-Based Cohort Study

Abstract

Objective: (1) To determine patterns of return to work (RTW) after traumatic brain injury and other causes of acquired brain injury (ABI) among young adults aged 19–30 years and (2) to compare the stability of long-term labor-market attachment (LMA) to the background population.Method: Nationwide registry-based inception cohort study of 10 years weekly data of employment status. Patients (n = 8,496) aged 19–30 years with first-ever diagnosis of TBI, stroke, subarachnoid hemorrhage, encephalopathy, brain tumor, or CNS infections during 1999–2015. For comparison, a general population cohort (n = 206,025) individually matched on age, sex, and municipality was identified. The main outcome was RTW, which was defined as time to LMA, i.e., a week without public assistance benefits except education grants/leave. Stable labor-market attachment (sLMA) was defined as LMA for at least 75% over 52 weeks. The cumulative incidence proportions of RTW and stable RTW in the ABI cohort were estimated with the Aalen-Johansen estimator with death as a competing event.Results: Twelve weeks after diagnosis 46.9% of ABI cohort had returned to stable RTW, which increased to 57.4% 1 year after, and 69.7% 10 years after. However, compared to controls fewer had sLMA 1 year (OR: 0.25 [95% CI 0.24–0.27]) and 10 years after diagnosis (OR: 0.35 [95% CI: 0.33–0.38]). Despite significant variations, sLMA was lower compared to the control cohort for all subtypes of ABI and no significant improvements were seen after 2–5 years.Conclusion: Despite relatively fast RTW only a minor proportion of young patients with ABI achieves sLMA.

Prevalence of depression after moderate to severe traumatic brain injury among adolescents and young adults: A systematic review

“…An increased risk of depression after a moderate to severe TBI in this group when compared to the general population may be related to a delay in the transition from adolescence into young adulthood as the sequelae from the TBI can limit the opportunity to gain independency, education and attachment to the labor market (Tibæk, Kammersgaard, Johnsen, Dehlendorff & Forchhammer, ). Moreover, an increased risk of depression could also be the result of peer victimization (Hung, Cassedy, Schultz et al., ) which appears to be related to psychosocial maladjustment and depression in adolescents without TBI (Hawker & Boulton, ).…”

Navigation ability in patients with acquired brain injury: A population-wide online study

“…Acquired brain injury (ABI) refers to brain injury following rapid onset damage to the brain after birth that is not caused by hereditary, congenital or degenerative events (Tibaek et al, 2018;Turner-Strokes, 2003). The most common types of ABIs result from cerebrovascular accidents (CVA), traumatic brain Injury (TBI) and brain tumours, whereas less common causes of ABIs include hypoxia, intoxication, and infection (Turner-Strokes, 2003).…”

Employment and Work Ability of Persons With Brain Tumors: A Systematic Review

“…The initial search returned 800 records. Following abstract screening and full text assessment, seven publications were selected for inclusion in this systematic review (Collins et al, 2013;Rusbridge et al, 2013;Al-Shudifat et al, 2014;Nugent et al, 2014;Pentsova et al, 2016;Starnoni et al, 2018;Tibaek et al, 2018). The rate of agreement between reviewers was 98% at the abstract check and 100% at full-text evaluation.…”

“…Two studies evaluated the impact of neuropsychological function on work ability (Collins et al, 2013;Nugent et al, 2014), two studies prospectively addressed employment status change (Rusbridge et al, 2013;Pentsova et al, 2016), three studies addressed the RTW process (Al-Shudifat et al, 2014;Starnoni et al, 2018;Tibaek et al, 2018).…”