The Glasgow Outcome Scale (GOS) is a widely used tool for measuring recovery after a traumatic brain injury. However, the GOS is based on the clinical perception of a person's capability and not a demonstration of ability. In addition, there are factors that influence a GOS score, but that may have little influence on actual outcome.
A recent study of people with moderate to severe traumatic brain injuries found that 61% of people who were able to live independently (a factor in GOS) had NOT returned to work. The researchers suggest that the predictors of independent living are not useful for predicting a successful return to work. Factors such as emotional status, substance abuse, personality, and social support may change after discharge and may therefore affect the actual ability to return to work.
When predicting the ability to return to work, clinicians must therefore consider a complex mix of factors, as well as changes that may occur over time.
Eastvold AD, Walker WC, Curtiss G, Schwab K, & Vanderploeg RD. Posttraumatic amnesia duration and time since injury in prediction of functional outcomes following moderate-to-severe traumatic brain injury. Journal of Head Trauma Rehabilitation. (March 2012).