What factors influence return to work after major traumatic injury?

Area of Science:

• Rehabilitation Medicine
• Occupational Health
• Traumatology

Background:

• Return-to-work (RTW) outcomes vary significantly for individuals with major traumatic injuries like traumatic brain injury (TBI), spinal cord injury (SCI), and multi-trauma orthopaedic (MTO) injuries.
• Understanding the interplay of injury, demographic, psychosocial factors, and vocational rehabilitation is crucial for improving RTW rates.

Purpose of the Study:

• To investigate the determinants of RTW likelihood and timing at one and two years post-injury.
• To examine the interaction between injury-related, demographic, psychosocial factors, and vocational rehabilitation in predicting RTW outcomes.

Main Methods:

• A cohort of 170 adults employed pre-injury, who participated in an early vocational rehabilitation trial, were followed up at one and two years post-injury.
• Data collected included injury type, demographic information, psychosocial status, and vocational rehabilitation access.
• Statistical analysis identified factors associated with employment status and time to RTW.

Main Results:

• At one and two years post-injury, 53.8% and 59.4% of participants were employed, respectively, with lower employment rates for individuals with SCI.
• Factors positively associated with RTW included being female, higher education, greater pre-injury work skills, absence of pre-injury psychological issues, and lower post-injury anxiety, depression, fatigue, and pain.
• Mean time to RTW was 189 days (1-year cohort) and 247 days (2-year cohort), with longer times for those with less education and lower pre-injury work skills.

Conclusions:

• Demographic characteristics, pre-injury psychological status, pre-injury employment factors, and post-injury sequelae significantly impact RTW after major traumatic injury.
• Early vocational rehabilitation plays a role, but must be complemented by addressing individual patient factors to optimize return to employment.