Abstract Details

Title Employment Trajectories and Productivity Outcomes at One-, Two-, and Five-years Following Traumatic Brain Injury With Disorder of Consciousness

Topic Neuro-rehabilitation

Presentation(s) P4 - Poster Session 4 (8:00 AM-9:00 AM)

Poster/Presentation
Number 14-008

Objective Assess the productivity outcomes and employment trajectories at 1-, 2-, and 5- years postinjury following inpatient rehabilitation for Traumatic Brain Injury (TBI) with Disorder of Consciousness (DoC).

Background Employment status is used as a marker of function and independence. Persons who are undergoing rehabilitation for chronic illness or injury often consider return to work as a key milestone in recovery. Within the population of persons with TBI diagnosed with a DoC, it is poorly understood what factors may contribute or hinder return-to-work. Our study aims to better understand the upstream and downstream determinants of employability and employment among persons with DoC.

Design/Methods

Participants were individuals with TBI enrolled into the TBI Model System National Database, a longitudinal study that collects data at 16 rehabilitation centers across the country. For this retrospective study, participants needed to be eligible for their 5-year follow-up window between June 25, 1998, and December 31, 2024, and have completed follow up interviews at 1-, 2-, and 5- years post-injury with complete employment data. Participants who were retired or age 65 or greater at the time of injury were excluded. Analyses assessed what extenuating factors (age, education, injury type, etc.) predicted higher likelihood for return-to-work in patients with DoC.

Results Employment, employability and productive participation gradually increase across years 1, 2, and 5 post-TBI. 15-17% of patients with DoC are employed by year 5 follow-up. Younger age and lower injury severity are associated with better long-term employment outcomes.

Conclusions These findings expand the knowledge base regarding meaningful long-term outcomes for this subpopulation. This information may be particularly useful in prognostic counseling after severe TBI allowing for more accurate and better-informed decisions in the context of treatment options and quality of life. Limitations include attrition in follow-up and lack of uniformity across centers.

Authors/Disclosures
Harrison Jacobs PRESENTER	Mr. Jacobs has received research support from NHLBI/NIH.
Natalie Gilmore, PhD	Dr. Gilmore has nothing to disclose.
Yelena Bodien, PhD (Spaulding Rehabilitation Hospital)	The institution of Dr. Bodien has received research support from NIH and NINDS. Dr. Bodien has received personal compensation in the range of $500-$4,999 for serving as a Co-inventor for the Updated Coma Recovery Scale-Revised with Spaulding Rehabilitation Hospital.
Andrew M. Brumett	Mr. Brumett has nothing to disclose.
Macy Deckard	Mrs. Deckard has nothing to disclose.
Tushar Sardesai	Mr. Sardesai has nothing to disclose.
Robert T. Woodburn, BS	Mr. Woodburn has nothing to disclose.
Therese O'Neil-Pirozzi, Speech-Language Pathologist	Dr. O'Neil-Pirozzi has nothing to disclose.
Brick B. Johnstone, PhD	Dr. Johnstone has nothing to disclose.
Joseph T. Giacino, PhD	The institution of Dr. Giacino has received research support from National Institute on Disability, Independent Living and Rehabilitation Research. The institution of Dr. Giacino has received research support from National Institute on Neurological Disorders and Stroke. The institution of Dr. Giacino has received research support from Department of Defense. The institution of Dr. Giacino has received research support from SameYou Foundation. Dr. Giacino has received intellectual property interests from a discovery or technology relating to health care.
Matthew Pease, MD	Mr. Pease has nothing to disclose.
Flora M. Hammond, MD	Dr. Hammond has received publishing royalties from a publication relating to health care.

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