Systematic review of return to work after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis

To synthesize the best available evidence on return to work (RTW) after mild traumatic brain injury (MTBI). MEDLINE and other databases were searched (2001-2012) with terms including "craniocerebral trauma" and "employment." Reference lists of eligible articles were also searched...

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Veröffentlicht in:Archives of physical medicine and rehabilitation Jg. 95; H. 3 Suppl; S. S201
Hauptverfasser: Cancelliere, Carol, Kristman, Vicki L, Cassidy, J David, Hincapié, Cesar A, Côté, Pierre, Boyle, Eleanor, Carroll, Linda J, Stålnacke, Britt-Marie, Nygren-de Boussard, Catharina, Borg, Jörgen
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Sprache:Englisch
Veröffentlicht: United States 01.03.2014
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ISSN:1532-821X, 1532-821X
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Abstract To synthesize the best available evidence on return to work (RTW) after mild traumatic brain injury (MTBI). MEDLINE and other databases were searched (2001-2012) with terms including "craniocerebral trauma" and "employment." Reference lists of eligible articles were also searched. Controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to assess RTW or employment outcomes in at least 30 MTBI cases. Eligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network criteria. Two reviewers independently reviewed and extracted data from accepted studies into evidence tables. Evidence was synthesized qualitatively according to modified Scottish Intercollegiate Guidelines Network criteria and prioritized according to design as exploratory or confirmatory. After 77,914 records were screened, 299 articles were found eligible and reviewed; 101 (34%) of these with a low risk of bias were accepted as scientifically admissible, and 4 of these had RTW or employment outcomes. This evidence is preliminary and suggests that most workers RTW within 3 to 6 months after MTBI; MTBI is not a significant risk factor for long-term work disability; and predictors of delayed RTW include a lower level of education (<11y of formal education), nausea or vomiting on hospital admission, extracranial injuries, severe head/bodily pain early after injury, and limited job independence and decision-making latitude. Our findings are based on preliminary evidence with varied patient characteristics and MTBI definitions, thus limiting firm conclusions. More well-designed studies are required to understand RTW and sustained employment after MTBI in the longer term (≥2y post-MTBI).
AbstractList To synthesize the best available evidence on return to work (RTW) after mild traumatic brain injury (MTBI). MEDLINE and other databases were searched (2001-2012) with terms including "craniocerebral trauma" and "employment." Reference lists of eligible articles were also searched. Controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to assess RTW or employment outcomes in at least 30 MTBI cases. Eligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network criteria. Two reviewers independently reviewed and extracted data from accepted studies into evidence tables. Evidence was synthesized qualitatively according to modified Scottish Intercollegiate Guidelines Network criteria and prioritized according to design as exploratory or confirmatory. After 77,914 records were screened, 299 articles were found eligible and reviewed; 101 (34%) of these with a low risk of bias were accepted as scientifically admissible, and 4 of these had RTW or employment outcomes. This evidence is preliminary and suggests that most workers RTW within 3 to 6 months after MTBI; MTBI is not a significant risk factor for long-term work disability; and predictors of delayed RTW include a lower level of education (<11y of formal education), nausea or vomiting on hospital admission, extracranial injuries, severe head/bodily pain early after injury, and limited job independence and decision-making latitude. Our findings are based on preliminary evidence with varied patient characteristics and MTBI definitions, thus limiting firm conclusions. More well-designed studies are required to understand RTW and sustained employment after MTBI in the longer term (≥2y post-MTBI).
To synthesize the best available evidence on return to work (RTW) after mild traumatic brain injury (MTBI).OBJECTIVETo synthesize the best available evidence on return to work (RTW) after mild traumatic brain injury (MTBI).MEDLINE and other databases were searched (2001-2012) with terms including "craniocerebral trauma" and "employment." Reference lists of eligible articles were also searched.DATA SOURCESMEDLINE and other databases were searched (2001-2012) with terms including "craniocerebral trauma" and "employment." Reference lists of eligible articles were also searched.Controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to assess RTW or employment outcomes in at least 30 MTBI cases.STUDY SELECTIONControlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to assess RTW or employment outcomes in at least 30 MTBI cases.Eligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network criteria. Two reviewers independently reviewed and extracted data from accepted studies into evidence tables.DATA EXTRACTIONEligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network criteria. Two reviewers independently reviewed and extracted data from accepted studies into evidence tables.Evidence was synthesized qualitatively according to modified Scottish Intercollegiate Guidelines Network criteria and prioritized according to design as exploratory or confirmatory. After 77,914 records were screened, 299 articles were found eligible and reviewed; 101 (34%) of these with a low risk of bias were accepted as scientifically admissible, and 4 of these had RTW or employment outcomes. This evidence is preliminary and suggests that most workers RTW within 3 to 6 months after MTBI; MTBI is not a significant risk factor for long-term work disability; and predictors of delayed RTW include a lower level of education (<11y of formal education), nausea or vomiting on hospital admission, extracranial injuries, severe head/bodily pain early after injury, and limited job independence and decision-making latitude.DATA SYNTHESISEvidence was synthesized qualitatively according to modified Scottish Intercollegiate Guidelines Network criteria and prioritized according to design as exploratory or confirmatory. After 77,914 records were screened, 299 articles were found eligible and reviewed; 101 (34%) of these with a low risk of bias were accepted as scientifically admissible, and 4 of these had RTW or employment outcomes. This evidence is preliminary and suggests that most workers RTW within 3 to 6 months after MTBI; MTBI is not a significant risk factor for long-term work disability; and predictors of delayed RTW include a lower level of education (<11y of formal education), nausea or vomiting on hospital admission, extracranial injuries, severe head/bodily pain early after injury, and limited job independence and decision-making latitude.Our findings are based on preliminary evidence with varied patient characteristics and MTBI definitions, thus limiting firm conclusions. More well-designed studies are required to understand RTW and sustained employment after MTBI in the longer term (≥2y post-MTBI).CONCLUSIONSOur findings are based on preliminary evidence with varied patient characteristics and MTBI definitions, thus limiting firm conclusions. More well-designed studies are required to understand RTW and sustained employment after MTBI in the longer term (≥2y post-MTBI).
Author Nygren-de Boussard, Catharina
Stålnacke, Britt-Marie
Cancelliere, Carol
Borg, Jörgen
Carroll, Linda J
Cassidy, J David
Hincapié, Cesar A
Kristman, Vicki L
Côté, Pierre
Boyle, Eleanor
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  givenname: Carol
  surname: Cancelliere
  fullname: Cancelliere, Carol
  email: ccancell@uhnresearch.ca
  organization: Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. Electronic address: ccancell@uhnresearch.ca
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  givenname: Vicki L
  surname: Kristman
  fullname: Kristman, Vicki L
  organization: Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada; Institute for Work and Health, Toronto, Ontario, Canada; Division of Human Sciences, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, Ontario, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
– sequence: 3
  givenname: J David
  surname: Cassidy
  fullname: Cassidy, J David
  organization: Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark
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  givenname: Cesar A
  surname: Hincapié
  fullname: Hincapié, Cesar A
  organization: Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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  givenname: Pierre
  surname: Côté
  fullname: Côté, Pierre
  organization: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada; UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Toronto, Ontario, Canada
– sequence: 6
  givenname: Eleanor
  surname: Boyle
  fullname: Boyle, Eleanor
  organization: Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark
– sequence: 7
  givenname: Linda J
  surname: Carroll
  fullname: Carroll, Linda J
  organization: School of Public Health and Alberta Centre for Injury Control and Research, University of Alberta, Alberta, Edmonton, Canada
– sequence: 8
  givenname: Britt-Marie
  surname: Stålnacke
  fullname: Stålnacke, Britt-Marie
  organization: Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå Sweden
– sequence: 9
  givenname: Catharina
  surname: Nygren-de Boussard
  fullname: Nygren-de Boussard, Catharina
  organization: Department of Clinical Sciences, Rehabilitation Medicine, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden
– sequence: 10
  givenname: Jörgen
  surname: Borg
  fullname: Borg, Jörgen
  organization: Department of Clinical Sciences, Rehabilitation Medicine, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden
BackLink https://www.ncbi.nlm.nih.gov/pubmed/24581906$$D View this record in MEDLINE/PubMed
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Employment
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Snippet To synthesize the best available evidence on return to work (RTW) after mild traumatic brain injury (MTBI). MEDLINE and other databases were searched...
To synthesize the best available evidence on return to work (RTW) after mild traumatic brain injury (MTBI).OBJECTIVETo synthesize the best available evidence...
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SubjectTerms Brain Injuries - diagnosis
Educational Status
Health Status
Humans
Occupations
Persons with Disabilities - statistics & numerical data
Prognosis
Return to Work - statistics & numerical data
Time Factors
Trauma Severity Indices
Title Systematic review of return to work after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis
URI https://www.ncbi.nlm.nih.gov/pubmed/24581906
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