Affiliations: [a] TBI Program, Centre de réadaptation Lucie-Bruneau, Montréal, Québec, Canada | [b] Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montréal, Québec, Canada | [c] Department of Psychology, Université de Montréal, Montréal, Québec, Canada | [d] Montreal Neurological Institute, Montréal, Québec, Canada
Correspondence:
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Address for correspondence: Michelle McKerral, Ph.D., Centre de recherche interdisciplinaire en réadaptation-Centre de réadaptation Lucie-Bruneau, 2275 Laurier Avenue East, Montréal, Québec, Canada H2H 2N8. Tel.: +1 514 527 4527, ext. 2530; Fax: +1 514 527 0979; E-mail: michelle.mckerral@umontreal.ca
Abstract: Beyond issues of MTBI etiology, a key question remains the characterization and early identification of those individuals at risk of poor functional outcome. Using a retrospective analysis, the current study aimed at identifying the specific indicators related to return to work in adults with both symptomatic MTBI and functional impacts, having completed a specialized intervention program. In terms of outcome, 59.1% of the cohort (n = 110) returned to some form of work-related activity by the end of intervention whereas the rest had not. Three of the sixteen variables studied were retained (logistic regression) as providing unique and significant (p < 0.05) contributions to the prediction outcome model, namely age, number of subjective symptoms and the presence of a public insurance provider. There was also an interaction between the presence of a public insurance provider and referral delay. Overall percentage of cases correctly classified by the model was 70%, positive predictive accuracy was 72.9%, whereas negative predictive accuracy was 65%. Our findings suggest that any studies attempting to assess functional outcome need to take account of the multifactorial nature of MTBI, including not only more objective psychological/physiological variables related to the injury, but also subjective complaints and environmental factors.
