Role of premorbid factors in predicting safe return to driving after severe TBI

Primary objective: The present study explored the possibility of predicting post-injury fitness to safe driving in patients with severe traumatic brain injury (TBI). Methods and procedure: Sixteen different measures, derived from four domains (demo/biographic, medico-functional, neuropsychological, and psychosocial) were used as predictor variables, whereas driving outcomes were assessed in terms of driving status (post-TBI drivers versus non-drivers) and driving safety (number of post-TBI car accidents and violations). Main outcomes and results: About 50% of the patients resumed driving after TBI. Compared to post-TBI non-drivers, post-injury drivers had shorter coma duration. With regard to driving safety, the final multiple regression model combined four predictors (years post-injury, accidents and violations before TBI, pre-TBI-risky-personality-index, andpre-TBI-risky-driving-style-index) and explained 72.5% of variance in the outcome measure. Conclusions: Since the best three predictors of post-injury driving safety addressed patients’ premorbid factors, the results suggest that in order to evaluate the actual possibility of safe driving after TBI, it would be advisable to consider carefully patients’ pre-TBI histories.