Labour market attachment after mild traumatic brain injury: nationwide cohort study with 5-year register followup in Denmark

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Heidi Jeannet Graff, Volkert Dirk Siersma, Anne Møller, Jakob Kragstrup, Lars L Andersen, Ingrid Egerod, Hana Malá Rytter

Objectives Sickness absence after mild traumatic brain
injury (mTBI) is frequent due to postconcussive symptoms.
We examined labour market attachment following mTBI up
to 5 years postinjury.
Design and setting Nationwide cohort study with register
follow-up.
Participants Patients between 18 and 60 years with
mTBI (International Classification of Diseases, version
10 diagnosis S06.0) were extracted from the Danish
National Patient Register (n=19 732). Controls were
matched on sex, age and municipality (n=18 640).
Patients with spinal cord and column injuries, traumatic
brain injury and concussions 5 years preinjury or as
secondary diagnosis to the concussion in the inclusion
period were excluded.
Primary and secondary outcome measures Data
were extracted from the Danish Register for Evaluation
of Marginalization. Primary outcome was ‘not attending
ordinary work’ defined as receiving any social transfer
payment. Secondary outcomes were health-related
benefits, limited attachment to the labour market,
permanent lack of attachment to the labour market and
death.
Results 5 years after diagnosis, 43% of patients were
not attending ordinary work. The odds increased from
6 months (OR 1.30, 95% CI 1.24 to 1.36) to 5 years (OR
1.54, 95% CI 1.45 to 1.63). The odds of health-related
benefits were 32% (OR 1.32, 95% CI 1.22 to 1.42) at 6
months and 22% (OR 1.22, 95% CI 1.12 to 1.33) at 5
years. Limited attachment to the labour market showed
increased odds at 5 years (OR 1.38, 95% CI 1.27 to 1.51)
and the odds of permanent lack of attachment to the labour market were higher for patients compared with controls (OR 2.59, 95% CI 2.30 to 2.92). Death was more than two times higher at 5 years postinjury (OR 2.62, 95% CI 2.10 to 3.26).
Conclusions 43% of concussed patients were not attending ordinary work 5 years postinjury and received health and social transfer benefits. We conclude that mTBI has a long-term impact on labour market attachment.
Prevention and treatment of persisting postconcussive symptoms should be considered.
Trial registration number NCT03214432; Results
Original languageEnglish
Article numbere026104
JournalBMJ Open
Volume9:e026104
Number of pages10
ISSN2044-6055
DOIs
Publication statusPublished - 2019

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