Workplace and non-workplace mild traumatic brain injuries in an outpatient clinic sample: A case-control study.
Workplace and non-workplace mild traumatic brain injuries in an outpatient clinic sample: A case-control study.
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DOI：
10.1371/journal.pone.0198128
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Silverberg ND
中科院分区：
文献类型：
--
作者：
Terry DP;Iverson GL;Panenka W;Colantonio A;Silverberg ND
在工作场所受伤的人通常有更大的风险延迟返回工作（RTW）和其他健康状况不佳的结果相比，那些没有在工作中受伤。目前尚不清楚这些差异是否适用于轻度创伤性脑损伤（MTBI）。本研究探讨了与工作场所和非工作场所MTBI摄入专业MTBI诊所，其结果和影响RTW的风险因素相关的差异。从2015年3月至2017年2月，从连续转诊到四家门诊MTBI诊所的患者中招募了恢复缓慢的参与者。两个诊所治疗工人赔偿索赔人，两个诊所为医疗保健系统中与工作无关的受伤病人提供服务。在273名符合条件的患者中，102名在受伤后平均2-3个月完成了初步研究评估（M年龄= 41.2岁，SD年龄= 11.7; 54%为女性）。参与者接受了关于他们的MTBI的采访，并完成了一系列标准化问卷和性能有效性测试。4-5个月后通过电话随访评估结局，包括RTW。工伤占样本的45.1%。与非工作场所MTBI组相比，工作场所MTBI组的男性比例更高，教育水平更低。两组有相当的脑震荡后症状负担和性能有效性测试失败率。工作场所的MTBI与更大的创伤后应激症状有关。15例患者（14.7%）失访。在伤后6-7个月，RTW结果没有工作场所/非工作场所MTBI差异。在整个样本中，42.5%的患者有完整的RTW，18.4%有部分RTW，39.1%没有RTW。更大的脑震荡后症状负担最能预测随访时无RTW。没有证据表明工作场所和非工作场所MTBI组有不同的风险因素与长期缺勤有关。尽管在补偿和医疗保健方面存在系统性差异，但工作场所和非工作场所MTBI组在诊所就诊时相似，在受伤后6-7个月的随访中无法区分。
Individuals who are injured in the workplace typically have a greater risk of delayed return to work (RTW) and other poor health outcomes compared to those not injured at work. It is not known whether these differences hold true for mild traumatic brain injuries (MTBI). The present study examined differences associated with workplace and non-workplace MTBI upon intake to a specialty MTBI clinic, their outcomes, and risk factors that influence RTW. Slow-to-recover participants were recruited from consecutive referrals to four outpatient MTBI clinics from March 2015 to February 2017. Two clinics treat Worker’s Compensation claimants and two clinics serve patients with non-work related injuries in the publically funded health care system. Of 273 eligible patients, 102 completed an initial study assessment (M age = 41.2 years, SD age = 11.7; 54% women) at an average of 2–3 months post injury. Participants were interviewed about their MTBI and completed a battery of standardized questionnaires and performance validity testing. Outcomes, including RTW, were assessed via telephone follow-up 4–5 months later. Workplace injuries comprised 45.1% of the sample. The workplace MTBI group had a greater proportion of men and lower education levels compared to the non-workplace MTBI group. The two groups had a comparable post-concussion symptom burden and performance validity test failure rate. Workplace MTBI was associated with greater post-traumatic stress symptoms. Fifteen patients (14.7%) were lost to follow-up. There were no workplace/non-workplace MTBI differences in RTW outcome at 6–7 months post injury. Of the entire sample, 42.5% of patients had full RTW, 18.4% had partial RTW, and 39.1% had no RTW. Greater post-concussion symptom burden was most predictive of no RTW at follow-up. There was no evidence that the workplace and non-workplace MTBI groups had different risk factors associated with prolonged work absence. Despite systemic differences in compensation and health care access, the workplace and non-workplace MTBI groups were similar at clinic intake and indistinguishable at follow-up, 6–7 months post injury.
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影响因子：
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作者：
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通讯作者：
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DOI：
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