What factors influence return to work after major traumatic injury?

There is considerable variability in return-to-work (RTW) outcomes for individuals with major traumatic injuries, including traumatic brain injury (TBI), spinal cord injury (SCI) and multi-trauma orthopaedic (MTO) injury. This study aimed to understand how injury-related, demographic and psychosocial factors and access to vocational rehabilitation interact to determine likelihood and time to RTW at one and two years post-injury. Participants were 170 adults employed pre-injury, enrolled in a trial of early vocational rehabilitation and followed up one- and/or two years post-injury. Of the 143 and 128 participants followed up, 53.8% and 59.4% were employed at one and two years post-injury. Employment was lowest for those with SCI. Factors associated with being employed at one and/or two years post-injury included being female, having more education, higher work skill level, no pre-injury psychological issues, and lower post-injury anxiety, depression, fatigue and pain. Mean time to RTW was 189 days for the one-year cohort and 247 days for the two-year cohort. Participants with less education and lower pre-injury work skills took longer to RTW. This study highlights the impact of demographic, pre-injury psychiatric issues, pre-injury employment and post-injury sequelae on return to employment after traumatic injury in addition to early vocational rehabilitation.Trial registration:Australian New Zealand Clinical Trials Registry identifier: ACTRN12619000521123.