4.2 Article

Characteristics and outcome of severe traumatic brain injuries based on occupational status

Journal

EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
Volume 47, Issue 6, Pages 2035-2041

Publisher

SPRINGER HEIDELBERG
DOI: 10.1007/s00068-020-01372-7

Keywords

Traumatic brain injury; Outcome; Occupational status; Epidemiology

Funding

  1. Austrian Ministry of Health
  2. Austrian Worker's Compensation Board [FK 11/2008, FK 11/2010]
  3. AUVA [FK 09/13]
  4. Trnava University [9/TU/2019, 14/TU/2019, 12/TU/2019]

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This study analyzed data from 13 centers in Austria, Croatia, Slovakia, Bosnia and Herzegovina, and Macedonia to investigate the relationship between occupational status and outcomes in traumatic brain injury patients. Different occupational groups showed variations in injury characteristics, with blue-collar workers and students having the most severe injuries. Retired individuals had the highest mortalities and unfavorable outcomes, while white-collar workers had the best outcomes. Adjusted odds ratios showed that all groups had higher odds of favorable outcomes at 6 months compared to retired patients.
Purpose The association of TBI with socioeconomic characteristics of patients has not been studied extensively. The objective of this study was to analyse the differences in injury characteristics and outcome in TBI patients based on their occupational status. Methods Data on patients from 13 centres based in Austria, Croatia, Slovakia, Bosnia and Herzegovina, and Macedonia were included in the analysis. Demographic characteristics, injury characteristics, treatment and outcome at various post-injury stages were compared according to occupational status. Logistic regression was used to adjust for the effect of co-variates. ICU mortality, hospital mortality, 6 months mortality, and outcome at 6 months were used as dependent variables. Results Overall, 886 patients were analysed with a mean age of 45.5 years. High-level falls were most prevalent in the blue-collar group (19%), most low-level falls occurred in the retired group. Traffic accidents were most common in students. The injuries were most severe in the blue-collar group and students. Highest mortalities and unfavourable outcomes were in the retired, students and white-collar workers had the best outcomes. Compared to retired patients, all groups had higher odds of favourable outcome at 6 months after adjusting for co-variates-OR from 2.2 (95% CI 1.1-4.6) for entrepreneurs to 3.6 (95% CI 1.8-7.2) for the blue-collar group. Conclusion Our paper provides clues pertaining specifically to variations in patterns and outcomes of TBI according to occupational status which can inform prevention and planning of services and can serve to plan priorities for further research.

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