A systematic review of return-to-work after mild traumatic brain injury: Results of the International Collaboration on MTBI Prognosis (ICoMP)

Carol Cancelliere, Vicki Kristman, John David Cassidy, Cesar A Hincapié, Pierre Côté, Eleanor Boyle, Linda Carroll, Britt-Marie Stålnacke, Catharina Nygren-de Boussard, Jörgen Borg

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review


Objective: To synthesize the best available evidence on return-to-work (RTW) after mild traumatic brain injury (MTBI).

Data sources: MEDLINE and other databases were searched (2001–2012) with terms including ‘craniocerebral trauma’ and ‘employment’. Reference lists of eligible articles were also searched.

Study selection: Controlled trials and cohort and case-control studies were selected according to pre-defined criteria. Studies had to assess RTW or employment outcomes in at least 30 MTBI cases.

Data extraction: Eligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network (SIGN) criteria. Two reviewers independently reviewed and extracted data from accepted studies into evidence tables.

Data synthesis: Evidence was synthesized qualitatively according to modified SIGN criteria and prioritized according to design as exploratory or confirmatory. After 77 911 records were screened; 299 articles were eligible and reviewed, 101 (34%) of these with a low risk of bias were accepted as scientifically admissible and four of these had RTW or employment outcomes. This evidence is preliminary and suggests that most workers RTW within 3–6 months after MTBI; MTBI is not a significant risk factor for long-term work disability; and predictors of delayed RTW include a lower level of education (<11 years of formal education), nausea or vomiting on hospital admission, extra-cranial injuries, severe head/bodily pain early after injury and limited job independence and decision-making latitude.

Conclusions: These findings are based on preliminary evidence with varied patient characteristics and MTBI definitions, thus limiting firm conclusions. More well-designed studies are required to understand RTW and sustained employment after MTBI in the longer term (≥2 years post-MTBI).
TidsskriftBrain Injury
Udgave nummer5-6
StatusUdgivet - 2014
BegivenhedTenth World Congress on Brain Injury - San Francisco, USA
Varighed: 19. mar. 201422. mar. 2014


KonferenceTenth World Congress on Brain Injury
BySan Francisco


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