Factors Determining Not Returning to Full-Time Work 12 Months After Mild Ischemic Stroke

Area of Science:

• Neurology
• Occupational Health
• Rehabilitation Medicine

Background:

• Mild ischemic stroke affects working-age individuals, impacting their ability to return to full-time employment.
• Understanding factors influencing return-to-work is crucial for effective post-stroke management and patient reintegration into the workforce.

Purpose of the Study:

• To determine the prevalence of not returning to full-time work one year after a first mild ischemic stroke.
• To identify demographic, clinical, and psychological factors associated with failure to return to full-time employment.

Main Methods:

• A prospective, observational cohort study was conducted with 84 cognitively healthy, full-time working patients (≤70 years) who experienced a first mild ischemic stroke (NIHSS ≤3).
• Data on vascular risk factors, sociodemographics, stroke characteristics, and post-stroke cognitive function, anxiety, depression, and fatigue were collected.
• Logistic regression analysis was used to identify predictors of not returning to full-time work at 12-month follow-up.

Main Results:

• Sixty percent (47/78) of patients returned to full-time employment one year post-stroke.
• A modified Rankin Scale score >1 at follow-up was significantly associated with not returning to full-time work (aOR 12.44, P=.003).
• Diabetes (aOR 10.56, P=.052), female sex, higher scores for anxiety, depression, and fatigue showed associations in unadjusted models.

Conclusions:

• Persistent functional limitations, indicated by a higher modified Rankin Scale score, are strongly linked to not returning to full-time work after a mild ischemic stroke.
• Factors such as diabetes, female sex, and psychological distress (fatigue, anxiety, depression) may also pose risks for sustained work absence.
• Post-stroke follow-up should focus on these factors to support patients' return to work and social participation.