Traumatic brain injury linked to long term risk of work disability
A Swedish study, recently published in the scientific journal Neurology, has found that individuals who have experienced a traumatic brain injury are more likely to face periods of work disability that can last for up to five years following the injury.
The researchers examined almost 100,000 adults treated in hospital or specialist outpatient care for a traumatic brain injury (TBI) and compared them with close to one million people without such an injury. Participants were observed over a period of five years, during which the frequency of their instances of work disability was measured. This term was defined as medically certified sickness absence lasting more than 14 days or disability pension.
To explore how injury severity influenced outcomes, the researchers divided TBIs into three groups: those who required neurosurgery, those hospitalised for three days or more without surgery, and those with the least severe injuries, treated in outpatient care or hospitalised for up to two days. All groups with traumatic brain injury (TBI) exhibited a higher probability of work disability in comparison with those who did not sustain such injuries.
Difference between injury groups
During the five-year period, 72 per cent of individuals with the most severe injuries experienced at least one period of work disability, compared with 67 per cent in the middle group and 45 per cent in the least severe group. In the non-injured comparison group, the figure was 26 per cent.
“These results demonstrate the potential for difficulties in work capacity to occur across all levels of traumatic brain injury,” says Elham Rostami, researcher at the Department of Neuroscience at Karolinska Institutet and the study’s principal investigator.
The study also found that patterns of work disability differed between groups. Severe injuries were found to be associated with an accelerated rate of disability, while individuals sustaining milder injuries exhibited a more gradual increase over time. The following factors were found to be associated with a higher risk in some TBI groups: older age, female sex and psychiatric or substance use disorders.
The researchers conclude that personalised rehabilitation may be important for reducing long-term work disability and supporting people’s return to work.
The study was conducted in collaboration with Ellenor Mittendorfer-Rutz, professor and head of division of insurance medicine at the Department of Clinical Neuroscience, Karolinska Institutet, and researchers at her division. See the study for funding and potential conflicts of interest.
Publication
"Five-Year Follow-Up of Work Disability After Traumatic Brain Injury: A Nationwide Swedish Matched Cohort Study of 98,000 Individuals", Klang A, Molero Y, Bergström J, Mittendorfer-Rutz E, Oldenburg C, Rostami E. Neurology, online 11 February 2026, doi:10.1212/WNL.0000000000214674.