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Factors Determining Not Returning to Full-Time Work 12 Months After Mild Ischemic Stroke
Georgios Vlachos1,2,3, Hege Ihle-Hansen1,2,4, Torgeir Bruun Wyller1,3
1Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
Objective:
To evaluate prevalence and factors determining not returning to full-time work 1 year after first-ever mild ischemic stroke.
Design:
Prospective, observational cohort study with 12-month follow-up.
Setting:
Stroke units and outpatient clinics at 2 Norwegian hospitals.
Participants:
We included 84 (N=84) full-time working, cognitively healthy patients aged 70 years or younger who suffered an acute first-ever mild ischemic stroke, defined as National Institutes of Health Stroke Scale (NIHSS) score ≤3 points.
Interventions:
Not applicable.
Main Outcome Measures:
Vascular risk factors, sociodemographic factors, stroke localization, and etiology were recorded at inclusion. Cognitive impairment, anxiety, depression, fatigue, and apathy 12 months after stroke were assessed with validated instruments. Logistic regression analyses were performed to find correlates of not returning to full-time employment.
Results:
Of 78 patients assessed 1 year after stroke, 63 (81%) had returned to work, 47 (60%) to full-time employment status. Modified Rankin scale score >1 (adjusted odds ratio, 12.44 [95% confidence interval, 2.37-65.43], P=.003) at follow-up was significantly associated, and diabetes (adjusted odds ratio, 10.56 [95% confidence interval, 0.98-113.47], P=.052) was borderline significantly associated with not returning to full-time work. Female sex, NIHSS at discharge, anxiety per point on the anxiety scale, depression per point on the depression scale, and fatigue per point on the fatigue scale were significantly associated with not returning to full-time work after 1 year, but these associations were only seen in the unadjusted models.
Conclusions:
Low functional level that persists 12 months after stroke is related to not returning to full-time work. Patients with diabetes mellitus, female patients, and patients with a higher score on fatigue, anxiety, and depression scales may also be at risk of not returning to full-time work post stroke. Working patients should be followed up with a particular focus on factors determining participation in work and social life.
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