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Sociodemographic differences in return to work after stroke: the South London Stroke Register (SLSR)
M A Busch1, C Coshall, P U Heuschmann
1King's College London, Division of Health and Social Care Research, London, UK. m.busch@rki.de
Journal of Neurology, Neurosurgery, and Psychiatry
|March 12, 2009
Summary
Return to work after stroke is low, with only 35% of survivors resuming paid employment within one year. Factors like Black ethnicity, female sex, older age, diabetes, and acute dependence significantly reduce return-to-work odds.
Area of Science:
- Neurology
- Public Health
- Occupational Medicine
Background:
- Employment loss significantly impacts individuals and society post-stroke.
- Limited data exists on factors influencing return to work (RTW) after stroke.
- Understanding RTW determinants is crucial for rehabilitation and support.
Purpose of the Study:
- To determine the frequency of return to paid work after stroke.
- To identify factors associated with return to paid work in a multi-ethnic urban population.
- To analyze sociodemographic and clinical predictors of RTW post-stroke.
Main Methods:
- Examined RTW patterns in a population-based stroke register (South London Stroke Register).
- Assessed employment status and functional outcomes (Barthel Index, Frenchay Activity Index) at 1 year post-stroke.
- Utilized multivariable logistic regression to analyze associations between baseline characteristics and RTW.
Main Results:
- Of 266 stroke survivors, 35% returned to paid work at 1 year.
- Lower RTW odds were associated with Black ethnicity, female sex, older age, diabetes, and acute dependence (BI ≤ 19).
- Improved functional outcomes correlated with RTW, yet many independent and active individuals did not resume work.
Conclusions:
- Sociodemographic factors significantly influence RTW post-stroke, independent of clinical variables.
- A substantial number of stroke survivors do not return to work, even with good functional recovery.
- Targeted interventions addressing sociodemographic disparities are needed to improve RTW rates.