People affected by traumatic brain injury (TBI) have an increased risk of work disability that can recur even years after the injury, regardless of its severity. This has been shown in a new national registry study from Uppsala University in collaboration with Karolinska Institutet (KI) and is based on close to 100,000 people with a traumatic brain injury.
TBI is caused by trauma to the head and can happen when a person falls or is in a traffic accident, for example. In the current study, the researchers investigated the relationship between TBI and work disability (sickness absence and disability pension or activity compensation).
“The results indicate that people who suffer from a traumatic brain injury often have lasting difficulties. Even minor injuries can affect their ability to be gainfully employed in the long term. People who have difficulty returning to work after a traumatic brain injury may need long-term, multidisciplinary care, where medical, psychiatric, social and work-related factors are assessed in combination,” says Elham Rostami, specialist in neurosurgery and the responsible researcher.
Based on data from close to 100,000 people living in Sweden
The study included nearly 100,000 people who had suffered a TBI and nearly one million people who had not suffered a TBI. The follow-up period was for up to five years.
The researchers categorised the severity of the TBIs into three groups based on the type of hospitalisation required:
Greater probability of work disability
All three groups had a higher probability of work disability compared to people without a TBI. During the five-year period, 45–72 per cent of the people with a TBI had had at least one period of work disability.
In the group without a TBI, the corresponding figure was 26 per cent.
In the case of more severe TBI, the probability of work disability was high immediately after the injury, while in the milder cases this risk increased more gradually during the follow-up period.
“We could see that even people with milder injuries had an increased risk of work disability and that it did not necessarily happen directly after the injury; it could also happen later. This may be due to the person returning to work, but when challenges arise later on, the person realises that they are unable to function as they did before the injury,” says Andrea Klang, doctoral student, specialist in rehabilitation medicine and the study’s lead author.
Higher age a factor in work disability
In all groups, being older carried an increased risk of work disability. In all groups, except those with the most severe TBI, it was found that people with psychiatric disorders or who had had periods of work disability before their TBI were more likely to transition to work disability following the TBI.
“Our study shows that the healthcare system needs to be more aware of the patients who do not recover fully and examine what support they need. They may also need support for a longer period of time – not just directly after the injury,” says Andrea Klang.
Facts
The study is based on data from the National Patient Register (NPR), Total Population Register, Longitudinal Integrated Database for Health Insurance and Labor Market Studies, the Cause of Death register, and the Micro-Data for Analysis of the Social Insurance System (MiDAS), which is a database that contains detailed information about sickness absence, activity compensation and disability pension for people in Sweden.
Neurology
Observational study
People
Five-Year Follow-Up of Work Disability After Traumatic Brain Injury
11-Feb-2026