Characterising early and late return to work following traumatic brain injury.

Facilitating successful return to work (RTW) is a key rehabilitation objective following traumatic brain injury (TBI). This study modelled early (within 6 months) and late (7-34 months) RTW by leveraging a large and comprehensive compensation database. The sample comprised 666 participants with TBI, the majority of whom sustained a moderate or severe injury caused by a motor vehicle accident. Early RTW was more likely for individuals who were pre-morbidly employed in a managerial or professional occupation (odds ratio [OR] = 2.1, confidence interval [CI] = 1.29-3.37), and those who experienced shorter post-traumatic amnesia (PTA) (OR = 0.96, CI = 0.94-0.98). RTW was less likely in the late phase for individuals who were older (hazard ratio [HR] = 0.99, CI = 0.98-1.00), experienced longer PTA (HR = 0.98, CI = 0.97-0.99), had an abdominal injury (HR = 0.90, CI = 0.67-1.21) and used more specialist practitioner (HR = 0.99, standard error [SE] = 0.98-1.00) and analgesic services (HR = 0.91, CI = 0.82-1.00). Conversely, RTW in the late phase was more likely for individuals using a greater number of specialist RTW supports (HR = 1.03, CI = 1.01-1.05). Patterns of early service utilization may therefore contribute to prediction of RTW outcome. It is encouraging that RTW was more likely for individuals using vocational supports.