Premorbid risk factors influencing labour market attachment after mild traumatic brain injury: a national register study with long-term follow-up

Abstract

Objectives Some patients with mild traumatic brain injury (mTBI) experience persistent postconcussive symptoms, influencing the ability to work. This study assessed associations between mTBI and labour market attachment (up to 5 years postinjury) in patients with different premorbid characteristics. Design and setting Danish national cohort study with 5-year register follow-up. Participants We included hospital admitted patients between 18 and 60 years diagnosed with mTBI (International Classification of Diseases, version 10 diagnosis S06.0) (n=19 732). For each patient, one control was selected matched on age, gender and municipality (n=18 640). Primary outcome measure Primary outcome was ‘not attending ordinary work’, and premorbid risk factors were cohabitation status, education, ethnicity, gender, age and comorbidities. Results The odds of not attending ordinary work increased from 6 months to 5 years. The highest increased odds (approximately twice as high for patients) of not attending ordinary work at 5 years were found in the highest educational group (OR 2.15, 95%\u2009CI 1.78 to 2.59), for patients of non-Danish origin (OR 1.98, 95%\u2009CI 1.52 to 2.57), for patients between 30 and 39 years (OR 1.93, 95%\u2009CI 1.68 to 1.23) and for patients with somatic comorbidities (OR 1.81, 95%\u2009CI 1.38 to 2.37). Contrary to expectations, we did not find higher odds in patients with psychiatric diagnoses (OR 1.12, 95%\u2009CI 0.76 to 1.60). Conclusions Important premorbid characteristics for lower labour market participation after mTBI were higher education, non-Danish origin, age 30–39 years and having somatic comorbidities. Demographic and health-related variables should be considered when assessing patients with mTBI at risk of long-term sickness absence. Trial registration number NCT03214432; Results.