Prognostic factors of return to work after traumatic or non-traumatic acquired brain injury

<i>Purpose</i>: To investigate and to determine evidence of prognostic factors for return to work (RTW) after acquired brain injury (ABI). <i>Method</i>: A systematic literature search was conducted in PubMed (2008–2014), applying terms for ABI and RTW. In addition, studies published after 2003 of a previous review on the same topic were added. The methodological quality of the included studies was assessed and evidence was classified. <i>Results</i>: Twenty-seven studies were included. There is <i>strong</i> evidence that a high education level is <i>positively</i> associated with RTW after traumatic ABI; a low education level, unemployment and length of stay in rehabilitation are <i>negatively</i> associated, and <i>a clear tendency</i> has been deduced from the studies that conscious state in the Emergency Department is <i>not</i> associated with RTW. <i>A</i>fter non-traumatic ABI, there is <i>strong</i> evidence that independence in activities of daily living is <i>positively</i> associated with RTW and aetiology of stroke is <i>not. Conclusions</i>: This study confirms earlier findings that after both traumatic and non-traumatic ABI injury related factors in the Emergency Department are <i>not</i> associated with RTW. In addition, it provides further evidence that <i>personal factors</i> after <i>traumatic</i> ABI and <i>activity-related factors</i> after <i>non-traumatic</i> ABI are strongly associated with RTW.Implications for RehabilitationWe found <i>strong</i> evidence for a significant association between RTW and <i>personal factors (education level, unemployment)</i> after <i>traumatic</i> ABI, and <i>activities of daily living (ADL)</i> after <i>non-traumatic</i> ABI.We advise to focus on <i>work-related activities</i> during the RTW process besides <i>ADL-training</i> and pay attention to and support patients <i>at risk</i> for not returning to work.