Evidence map›Paper›PMID 34046212›Full record

ArticleJournal of concussion

Predictors of six-month inability to return to work in previously employed subjects after mild traumatic brain injury: A TRACK-TBI pilot study.

John K Yue, Ryan Rl Phelps, Debra D Hemmerle, Pavan S Upadhyayula, Ethan A Winkler, Hansen Deng, Diana Chang, Mary J Vassar, Sabrina R Taylor, David M Schnyer and 11 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of concussion. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
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  3. Review
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  5. Article
  6. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 7 institutions in 2 countries.

John K YueDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.ORCID 0000-0001-9694-7722
Ryan Rl PhelpsDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
Debra D HemmerleDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.ORCID 0000-0003-2796-6107
Pavan S UpadhyayulaDepartment of Neurological Surgery, University of California San Diego, San Diego, CA, USA.
Ethan A WinklerDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
Hansen DengDepartment of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Diana ChangDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
Mary J VassarDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
Sabrina R TaylorDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
David M SchnyerDepartment of Psychology, University of Texas, Austin, TX, USA.
Hester F LingsmaDepartment of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands.
Ava M PuccioDepartment of Neurological Surgery, University of California San Diego, San Diego, CA, USA.
Esther L YuhBrain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA.
Pratik MukherjeeBrain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA.
Michael C HuangDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
Laura B NgwenyaDepartment of Neurological Surgery, University of Cincinnati, Cincinnati, OH, USA.
Alex B ValadkaDepartment of Neurological Surgery, Virginia Commonwealth University, Richmond, VA, USA.
Amy J MarkowitzBrain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA.
David O OkonkwoDepartment of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Geoffrey T ManleyDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
TRACK-TBI Investigators
San Francisco General Hospital · USUniversity of California San Diego · USUniversity of Pittsburgh Medical Center · USErasmus MC · NLNeurological Surgery · USThe University of Texas at Austin · USVirginia Commonwealth University · US

Funding

Transforming Research and Clinical Knowledge in Traumatic Brain InjuryU01NS086090 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI DIAZ-ARRASTIA, RAMON, GIACINO, JOSEPH THOMAS · 2013 to 2017
$19.1M
Transforming Traumatic Brain Injury Research and Clinical CareRC2NS069409 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MANLEY, GEOFFREY T · 2009 to 2011
$4.3M
Clinical Validation of Serum Neurofilament Light as a Biomarker of Traumatic Axonal InjuryU01NS114140 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI DIAZ-ARRASTIA, RAMON · 2020 to 2025
$3.9M
NINDS NIH HHS RC2 NS069409NINDS NIH HHS U01 NS086090NINDS NIH HHS U01 NS114140
6 · The paper itself

Abstract

introductionReturn to work (RTW) is an important milestone of mild traumatic brain injury (mTBI) recovery. The objective of this study was to evaluate whether baseline clinical variables, three-month RTW, and three-month postconcussional symptoms (PCS) were associated with six-month RTW after mTBI.

methodsAdult subjects from the prospective multicenter Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot study with mTBI (Glasgow Coma Scale 13-15) who were employed at baseline, with completed three-and six-month RTW status, and three-month Acute Concussion Evaluation (ACE), were extracted. Univariate and multivariable analyses were performed for six-month RTW, with focus on baseline employment, three-month RTW, and three-month ACE domains (physical, cognitive, sleep, and/or emotional postconcussional symptoms (PCS)). Odds ratios (OR) and 95% confidence intervals [CI] were reported. Significance was assessed at p < 0.05.

resultsIn 152 patients aged 40.7 ± 15.0years, 72% were employed full-time at baseline. Three- and six-month RTW were 77.6% and 78.9%, respectively. At three months, 59.2%, 47.4%, 46.1% and 31.6% scored positive for ACE physical, cognitive, sleep, and emotional PCS domains, respectively. Three-month RTW predicted six-month RTW (OR = 19.80, 95% CI [7.61-51.52]). On univariate analysis, scoring positive in any three-month ACE domain predicted inability for six-month RTW (OR = 0.10-0.11). On multivariable analysis, emotional symptoms predicted inability to six-month RTW (OR = 0.19 [0.04-0.85]). Subjects who scored positive in all four ACE domains were more likely to be unable to RTW at six months (4 domains: 58.3%, vs. 0-to-3 domains: 9.5%; multivariable OR = 0.09 [0.02-0.33]).

conclusionsThree-month post-injury is an important time point at which RTW status and PCS should be assessed, as both are prognostic markers for six-month RTW. Clinicians should be particularly vigilant of patients who present with emotional symptoms, and patients with symptoms across multiple PCS categories, as these patients are at further risk of inability to RTW and may benefit from targeted evaluation and support.

Indexed as

Concussiondisabilitymild traumatic brain injurypost-concussion syndromereturn to work

Identifiers

PMID34046212
PMCPMC8153496
OpenAlexW3150140764

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.