Early predictors of employment outcomes 1 year post traumatic brain injury in a population of Hispanic individuals

Issue title: Spanish Speakers with Neurological and Psychiatric Disabilities: Relevant Factors Related to Rehabilitation

Guest editors: Juan Carlos Arango-Lasprilla

Article type: Research Article

Authors: Ketchum, Jessica M.^{a; *} | Almaz Getachew, Mimi^b | Krch, Denise^{c; f} | Baños, James H.^d | Kolakowsky-Hayner, Stephanie A.^e | Lequerica, Anthony^{c; f} | Jamison, Laura^e | Arango-Lasprilla, Juan Carlos^b

Affiliations: [a] Department of Biostatistics and The Center for Rehabilitation Science and Engineering, Virginia Commonwealth University, Richmond, VA, USA | [b] Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA | [c] Kessler Foundation Research Center, West Orange, NJ, USA | [d] Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA | [e] Rehabilitation Research Center, Santa Clara Valley Medical Center, CA, USA | [f] Department of Physical Medicine and Rehabilitation, UMDNJ – New Jersey Medical School, Newark, NJ, USA | Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA

Correspondence: [*] Corresponding author: Jessica M. Ketchum, Virginia Commonwealth University, Department of Biostatistics, P.O. Box 980032, Richmond, VA 23298-0032, USA. Tel.: +1 804 827 2057; Fax: +1 804 828 8900; E-mail: [email protected]

Abstract: Objective:To determine which demographic, injury, and rehabilitation factors are associated with employment rates in Hispanic individuals 1 year post traumatic brain injury (TBI). Design:Retrospective study. Setting:Longitudinal dataset of the TBI Model Systems National Database. Participants:418 Hispanic individuals with TBI hospitalized between 1990 and 2009 having year 1 follow-up data (18–55 years and not retired at injury). Main outcome measure:Competitive employment status 1 year post-injury (yes/no). Results:A multiple logistic regression model indicated that pre-injury employment status, pre-injury level of education, etiology, days of posttraumatic amnesia (PTA), associated spinal cord injury, Functional Independence Measure (FIM) motor at rehabilitation discharge, and length of stay in rehabilitation were significant predictors of competitive employment post-injury, controlling for the effects of each other (all p-values ⩽ 0.014). Increases in the odds of not being employed post-injury were associated with not being employed pre-injury, having lower levels of education pre-injury, etiologies due to violence or falls, increased PTA, an associated spinal cord injury, lower FIM motor scores, and greater lengths of stay in rehabilitation. Conclusions:The first year post-TBI is critical for recovery and gainful employment, particularly for Hispanic individuals. Early identification of factors influencing successful gainful employment and expeditious implementation of services to ameliorate these issues are paramount in improving employment outcomes for Hispanic individuals with TBI.

Keywords: Employment, traumatic brain injury, hispanics

DOI: 10.3233/NRE-2011-0723

Journal: NeuroRehabilitation, vol. 30, no. 1, pp. 13-22, 2012