上肢或下肢长骨折后重返工作:日本多中心队列研究中的社会因素
Keisuke Ishii1, Hiroyuki Oka2, Koichi Inokuchi3
1Trauma and Reconstruction Center, Teikyo University Hospital, Tokyo, Japan.
JMA journal
|February 10, 2025
概括
诸如非正规就业等社会因素会推迟骨折后早期返回工作 (RTW). 然而,这些因素在日本受伤后的两年内没有影响RTW.
科学领域:
- 整形外科 整形外科 整形外科
- 职业健康 职业健康 职业健康
- 社会经济学 社会经济学
背景情况:
- 骨折严重阻碍了就业,影响个人和经济.
- 在日本,关于社会决定因素的证据有限,例如非正规就业,影响伤害后恢复工作 (RTW).
研究的目的:
- 调查社会因素与日本受伤后的RTW之间的关联.
- 确定影响手术骨折修复后RTW时间和速率的特定社会决定因素.
主要方法:
- 多中心队列研究 (2015-2018) 包括674名经过手术治疗的长骨折患者 (18-65岁).
- 主要结果:受伤后6个月,1年和2年的RTW率.
- 对患者和骨折因素进行调整后的物流回归和Cox比例危险模型.
主要成果:
- 总体而言,RTW率在6个月内为77.9%,在2年内为89.3%.
- 身体劳动,开放骨折和慢性疼痛与6个月和2年的RTW相关.
- 非正规就业和工人赔偿保险仅与6个月的RTW相关;社会因素影响了早期RTW,但没有影响长期恢复.
结论:
- 大约10%的患者在两年内没有回到工作位.
- 社会因素,特别是非正规就业,构成延迟早期RTW的风险.
- 调查结果表明,需要在政策层面采取干预措施,以支持受伤工人的RTW.
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