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Acquired Brain Injury Among Adolescents and Young Adults: A Nationwide Study of Labor Market Attachment

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Abstract

Purpose Young patients represent a particularly vulnerable group regarding vocational prognosis after an acquired brain injury (ABI). We aimed to investigate how sequelae and rehabilitation needs are associated with vocational prognosis up to 3 years after an ABI in 15–30-year-old patients. Methods An incidence cohort of 285 patients with ABI completed a questionnaire on sequelae and rehabilitation interventions and needs 3 months after the index hospital contact. They were followed-up for up to 3 years with respect to the primary outcome “stable return to education/work (sRTW)”, which was defined using a national register of public transfer payments. Data were analyzed using cumulative incidence curves and cause-specific hazard ratios. Results Young individuals reported a high frequency of mainly pain-related (52%) and cognitive sequelae (46%) at 3 months. Motor problems were less frequent (18%), but negatively associated with sRTW within 3 years (adjusted HR 0.57, 95% CI 0.39–0.84). Rehabilitation interventions were received by 28% while 21% reported unmet rehabilitation needs, and both factors were negatively associated with sRTW (adjusted HR 0.66, 95% CI 0.48–0.91 and adjusted HR 0.72, 95% CI 0.51–1.01). Conclusions Young patients frequently experienced sequelae and rehabilitation needs 3 months post ABI, which was negatively associated with long-term labor market attachment. The low rate of sRTW among patients with sequelae and unmet rehabilitation needs indicates an untapped potential for ameliorated vocational and rehabilitating initiatives targeted at young patients.

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Data Availability

Data from The National Study of Young Brain Injury Survivors are available through The Danish Clinical Quality Program – National Clinical Registries (https://www.rkkp.dk/in-english/) under standard conditions.

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Acknowledgements

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Funding

The study was funded by the Danish Ministry of Health and the Capital Region of Denmark. The funding sources did not play any role in the design, data collection and analyses, preparation of the manuscript or decision to publish.

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Authors and Affiliations

  1. Department of Neurology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark

    M. S. Worm

  2. Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark

    M. S. Worm & J. F. Thomsen

  3. Danish Centre for Health Economics, DaCHE, University of Southern Denmark, Odense, Denmark

    M. Kruse

  4. Department of Clinical Medicine, Danish Center for Clinical Health Services Research, Aalborg University and Aalborg University Hospital, Aalborg, Denmark

    J. B. Valentin & S. P. Johnsen

  5. Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark

    S. W. Svendsen & J. F. Nielsen

  6. Danish Ramazzini Centre, Department of Occupational Medicine - University Research Clinic, Herning Hospital, Herning, Denmark

    S. W. Svendsen

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Contributions

MSW and SWS conceived the study and all authors contributed to the study design. Material preparation and analysis were performed by MSW, MK and JBV. The first draft of the manuscript was written by MSW and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to M. S. Worm.

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Worm, M.S., Kruse, M., Valentin, J.B. et al. Acquired Brain Injury Among Adolescents and Young Adults: A Nationwide Study of Labor Market Attachment. J Occup Rehabil 33, 592–601 (2023). https://doi.org/10.1007/s10926-023-10097-4

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