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Return to Work After Ischemic Stroke in Young Adults: A Multicenter Cohort Study, Systematic Review, and
Gabriel Yi Ren Kwok1, Nicole Yeong2, Michelle Law2
1Barts and The London School of Medicine and Dentistry, Queen Mary University of London London UK.
Journal of the American Heart Association
|April 3, 2025
Summary
Return to work (RTW) after ischemic stroke is crucial for young adults. Factors like large-artery atherosclerosis, diabetes, and stroke severity impact RTW rates, highlighting a need for targeted rehabilitation strategies.
Area of Science:
- Neurology
- Public Health
- Rehabilitation Medicine
Background:
- Global incidence of ischemic stroke in young adults is rising.
- Return to work (RTW) is a primary rehabilitation objective for this demographic.
- Understanding factors influencing RTW is critical for effective post-stroke care.
Purpose of the Study:
- To determine the proportion of young adults who return to work after ischemic stroke.
- To identify patient characteristics associated with RTW.
- To augment cohort findings with a systematic review and meta-analysis.
Main Methods:
- Retrospective cohort study of ischemic stroke patients aged 18-50 years in Singapore (2020-2022).
- Systematic review and meta-analysis of studies from January 2000 to November 2023.
- Evaluation of associations between patient characteristics and 3-month RTW status using logistic regression and random-effects models.
Main Results:
- In the Singapore cohort, 68.8% of young adults returned to work, and 87.8% achieved functional recovery.
- Large-artery atherosclerosis, diabetes, higher NIH Stroke Scale scores, and higher mRS scores were associated with lower RTW odds.
- Meta-analysis of 1914 patients showed pooled RTW proportion of 63.2% and functional recovery of 84.7%.
Conclusions:
- Young adults with large-artery atherosclerosis, diabetes, and severe strokes have reduced likelihood of returning to work.
- A significant number of patients achieving functional recovery do not return to work, indicating a disparity.
- Further research is needed to understand and address the reasons behind this RTW-functional recovery gap.
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