Injury severity measures for predicting return-to-work after a traumatic brain injury

Ding Kuo Chien, Hei Fen Hwang, Mau Roung Lin

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

This study compared the ability of five injury severity measures, namely the Abbreviated Injury Scale to the Head (AIS-H), Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS), Extended Glasgow Outcome Scale (GOSE), and Injury Severity Score (ISS), to predict return-to-work after a traumatic brain injury (TBI). Furthermore, factors potentially associated with return-to-work were investigated. In total, 207 individuals aged ≤65 years newly diagnosed with a TBI and employed at the time of injury were recruited and followed-up for 1 year by telephone every 3 months. A bivariate proportional hazards model analysis revealed that all five injury severity measures were significantly associated with return-to-work after a TBI. The AIS-H and non-head ISS explained 23.8% of the variation in the duration of returning to work from discharge after hospitalization for a TBI; similarly, the GCS, GOS, GOSE, and ISS respectively accounted for 4.7%, 21.4%, 12.9%, and 48.4% of the variation. A multivariable analysis revealed that individuals with higher injury severity as measured by the ISS (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.92–0.97), a lack of autonomy in transportation (HR, 2.55; 95% CI, 1.23–5.32), cognitive impairment (HR, 0.47; 95% CI, 0.28–0.79), and depression (HR, 0.97; 95% CI, 0.95–0.99) were significantly less likely to be employed after a TBI. In conclusion, of the five injury severity measures, the ISS may be the most capable measure of predicting return-to-work after a TBI. In addition to injury severity, autonomy in transportation, cognitive function, and the depressive status may also influence the employment status during the first year after a TBI.

Original languageEnglish
Pages (from-to)101-107
Number of pages7
JournalAccident Analysis and Prevention
Volume98
DOIs
Publication statusPublished - Jan 1 2017

Fingerprint

Return to Work
Injury Severity Score
Brain
brain
Glasgow Outcome Scale
Hazards
Wounds and Injuries
confidence
Abbreviated Injury Scale
Confidence Intervals
Glasgow Coma Scale
autonomy
Head
Aptitude
model analysis
Traumatic Brain Injury
Telephone
hospitalization
Proportional Hazards Models
Cognition

Keywords

  • AIS
  • Employment
  • Injury severity
  • ISS
  • Return-to-work
  • Traumatic brain injury

ASJC Scopus subject areas

  • Human Factors and Ergonomics
  • Safety, Risk, Reliability and Quality
  • Public Health, Environmental and Occupational Health
  • Law

Cite this

Injury severity measures for predicting return-to-work after a traumatic brain injury. / Chien, Ding Kuo; Hwang, Hei Fen; Lin, Mau Roung.

In: Accident Analysis and Prevention, Vol. 98, 01.01.2017, p. 101-107.

Research output: Contribution to journalArticle

@article{53cc0b7f5b7b4dc5a85c834b474b8e5f,
title = "Injury severity measures for predicting return-to-work after a traumatic brain injury",
abstract = "This study compared the ability of five injury severity measures, namely the Abbreviated Injury Scale to the Head (AIS-H), Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS), Extended Glasgow Outcome Scale (GOSE), and Injury Severity Score (ISS), to predict return-to-work after a traumatic brain injury (TBI). Furthermore, factors potentially associated with return-to-work were investigated. In total, 207 individuals aged ≤65 years newly diagnosed with a TBI and employed at the time of injury were recruited and followed-up for 1 year by telephone every 3 months. A bivariate proportional hazards model analysis revealed that all five injury severity measures were significantly associated with return-to-work after a TBI. The AIS-H and non-head ISS explained 23.8{\%} of the variation in the duration of returning to work from discharge after hospitalization for a TBI; similarly, the GCS, GOS, GOSE, and ISS respectively accounted for 4.7{\%}, 21.4{\%}, 12.9{\%}, and 48.4{\%} of the variation. A multivariable analysis revealed that individuals with higher injury severity as measured by the ISS (hazard ratio [HR], 0.94; 95{\%} confidence interval [CI], 0.92–0.97), a lack of autonomy in transportation (HR, 2.55; 95{\%} CI, 1.23–5.32), cognitive impairment (HR, 0.47; 95{\%} CI, 0.28–0.79), and depression (HR, 0.97; 95{\%} CI, 0.95–0.99) were significantly less likely to be employed after a TBI. In conclusion, of the five injury severity measures, the ISS may be the most capable measure of predicting return-to-work after a TBI. In addition to injury severity, autonomy in transportation, cognitive function, and the depressive status may also influence the employment status during the first year after a TBI.",
keywords = "AIS, Employment, Injury severity, ISS, Return-to-work, Traumatic brain injury",
author = "Chien, {Ding Kuo} and Hwang, {Hei Fen} and Lin, {Mau Roung}",
year = "2017",
month = "1",
day = "1",
doi = "10.1016/j.aap.2016.09.025",
language = "English",
volume = "98",
pages = "101--107",
journal = "Accident Analysis and Prevention",
issn = "0001-4575",
publisher = "Elsevier Limited",

}

TY - JOUR

T1 - Injury severity measures for predicting return-to-work after a traumatic brain injury

AU - Chien, Ding Kuo

AU - Hwang, Hei Fen

AU - Lin, Mau Roung

PY - 2017/1/1

Y1 - 2017/1/1

N2 - This study compared the ability of five injury severity measures, namely the Abbreviated Injury Scale to the Head (AIS-H), Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS), Extended Glasgow Outcome Scale (GOSE), and Injury Severity Score (ISS), to predict return-to-work after a traumatic brain injury (TBI). Furthermore, factors potentially associated with return-to-work were investigated. In total, 207 individuals aged ≤65 years newly diagnosed with a TBI and employed at the time of injury were recruited and followed-up for 1 year by telephone every 3 months. A bivariate proportional hazards model analysis revealed that all five injury severity measures were significantly associated with return-to-work after a TBI. The AIS-H and non-head ISS explained 23.8% of the variation in the duration of returning to work from discharge after hospitalization for a TBI; similarly, the GCS, GOS, GOSE, and ISS respectively accounted for 4.7%, 21.4%, 12.9%, and 48.4% of the variation. A multivariable analysis revealed that individuals with higher injury severity as measured by the ISS (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.92–0.97), a lack of autonomy in transportation (HR, 2.55; 95% CI, 1.23–5.32), cognitive impairment (HR, 0.47; 95% CI, 0.28–0.79), and depression (HR, 0.97; 95% CI, 0.95–0.99) were significantly less likely to be employed after a TBI. In conclusion, of the five injury severity measures, the ISS may be the most capable measure of predicting return-to-work after a TBI. In addition to injury severity, autonomy in transportation, cognitive function, and the depressive status may also influence the employment status during the first year after a TBI.

AB - This study compared the ability of five injury severity measures, namely the Abbreviated Injury Scale to the Head (AIS-H), Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS), Extended Glasgow Outcome Scale (GOSE), and Injury Severity Score (ISS), to predict return-to-work after a traumatic brain injury (TBI). Furthermore, factors potentially associated with return-to-work were investigated. In total, 207 individuals aged ≤65 years newly diagnosed with a TBI and employed at the time of injury were recruited and followed-up for 1 year by telephone every 3 months. A bivariate proportional hazards model analysis revealed that all five injury severity measures were significantly associated with return-to-work after a TBI. The AIS-H and non-head ISS explained 23.8% of the variation in the duration of returning to work from discharge after hospitalization for a TBI; similarly, the GCS, GOS, GOSE, and ISS respectively accounted for 4.7%, 21.4%, 12.9%, and 48.4% of the variation. A multivariable analysis revealed that individuals with higher injury severity as measured by the ISS (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.92–0.97), a lack of autonomy in transportation (HR, 2.55; 95% CI, 1.23–5.32), cognitive impairment (HR, 0.47; 95% CI, 0.28–0.79), and depression (HR, 0.97; 95% CI, 0.95–0.99) were significantly less likely to be employed after a TBI. In conclusion, of the five injury severity measures, the ISS may be the most capable measure of predicting return-to-work after a TBI. In addition to injury severity, autonomy in transportation, cognitive function, and the depressive status may also influence the employment status during the first year after a TBI.

KW - AIS

KW - Employment

KW - Injury severity

KW - ISS

KW - Return-to-work

KW - Traumatic brain injury

UR - http://www.scopus.com/inward/record.url?scp=84989929412&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84989929412&partnerID=8YFLogxK

U2 - 10.1016/j.aap.2016.09.025

DO - 10.1016/j.aap.2016.09.025

M3 - Article

VL - 98

SP - 101

EP - 107

JO - Accident Analysis and Prevention

JF - Accident Analysis and Prevention

SN - 0001-4575

ER -