Abstract Details

Title Psychosocial Factors Affecting Return-to-Work for Patients With Persistent Post Concussive Syndrome

Topic Neuro-rehabilitation

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

Poster/Presentation
Number 14-009

Objective To identify factors associated with return-to-work (RTW) in patients with persistent post concussive syndrome (PPCS) following mild traumatic brain injury (mTBI).

Background RTW is a leading concern for chronic TBI patients but factors influencing RTW in symptomatic patients remain underexplored. We hypothesize that for patients with chronic PPCS, the ability to achieve RTW is influenced by psychosocial factors, rather than injury-related characteristics alone.

Design/Methods A single-center retrospective study (7/2024-8/2025) was performed including PPCS patients (defined as mTBI [GCS >13], ≥3 months post-injury with high concussion symptom criteria [score ≥12/64] in the Rivermead Post Concussion scale) who presented to our TBI-clinic. Primary outcome: RTW by index clinic visit. Univariate statistics and logistic regression were performed. Covariates included age, sex, injury severity score (ISS), time from TBI to clinic, psychosocial factors (post-TBI psychiatric diagnosis, marital status), and occupation.

Results Of 69 mTBI patients with PPCS (mean age 48 ±15; 49.3% female; median months since injury 8 (IQR: 5–37)), 49.3% achieved RTW status. There were no differences in the RTW and no-RTW cohort regarding mechanism of injury, ISS, and positive head CT findings. However, patients who achieved RTW were more often married (55.9% vs 28.6%, p=0.04), had lower rates of post-TBI psychiatric diagnoses (5.9% vs 28.6%, p= 0.03), and a shorter time from injury to clinic-evaluation (median 5.5 vs 25 months, p=0.002). On multivariable analysis, being married remained an independent predictor of RTW (OR = 5.19, 95% CI 1.52–17.79, p=0.009).

Conclusions Less than half of mTBI patients with PPCS achieved RTW, with the only predictive factor being that the patient was married. Intimate social support may have a positive effect on this important patient-centric outcome, with psychiatric vulnerability potentially hindering RTW.

Authors/Disclosures
Maria Thereza Paulino PRESENTER	Miss Paulino has nothing to disclose.
Amanda Fang, Undergraduate student	Miss Fang has nothing to disclose.
Stephania B. Tovar Vargas, MPH	Ms. Tovar Vargas has nothing to disclose.
Maral Sakayan, MD (UCI Department of Neurology)	Dr. Sakayan has nothing to disclose.
Danh V. Nguyen, PhD	Prof. Nguyen has nothing to disclose.
Mark Mapstone, PhD (University of California, Irvine)	Dr. Mapstone has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Brain Neurotherapy Bio, Inc. Dr. Mapstone has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alzheon, Inc. Dr. Mapstone has received intellectual property interests from a discovery or technology relating to health care.
Sigrid Burruss, MD	The institution of Dr. Burruss has received research support from BSCC CalVIP.
Areg Grigorian	Areg Grigorian has nothing to disclose.
Jeffry Nahmias, MD, MHPE	Dr. Nahmias has nothing to disclose.
Michael Lopez, PhD	Michael Lopez has nothing to disclose.
Bernadette Boden-Albala, DrPH (University California Irvine)	Ms. Boden-Albala has received research support from NIH.
Patrick M. Chen, MD (UC Irvine Medical Center)	Dr. Chen has nothing to disclose.

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