To investigate the relationship between cognitive function and return to work (RTW) within the first year following traumatic brain injury (TBI), 320 adults enrolled in the TBI Model System National Database who were competitively employed at injury were interviewed at 1 year follow-up. Cognitive status was assessed using the Brief Test of Adult Cognition by Telephone (BTACT). Employment status and RTW time were also assessed. Higher BTACT scores were significantly associated with increased odds of RTW and faster RTW time. Insights from this presentation may help clinicians focus on cognitive remediation or compensation to improve RTW outcomes following TBI.
Objective: To assess the contribution of a brief telephone assessment of cognitive function on prediction of return to work at 1 year following moderate to severe traumatic brain injury (TBI).
Design: Prospective cross-sectional observational cohort study.
Setting: Seventeen Traumatic Brain Injury Model Systems.
Participants: Persons 18-64 years old with moderate to severe TBI who were enrolled in the TBI Model Systems National Database and were competitively employed at the time of injury (N = 320).
Main Measures: The Brief Test of Adult Cognition by Telephone (BTACT), employment status, and time to return to work (RTW), collected at 1 year follow-up interview. Covariates included known predictors of RTW including demographic factors, injury severity, substance misuse, and transportation.
Results: At 1 year post TBI, 39% of participants were competitively employed. Survival analysis of time to RTW indicated that 25% of participants had returned to work by 165 days post-injury TBI (95% CI = 141, 217). Multivariable analyses revealed that increased BTACT composite scores significantly predicted both increased odds of RTW and shorter time to RTW, over and above the contribution of established predictors. Female sex and resumption of driving at 1 year also significantly predicted higher odds and shorter time for RTW.