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Return to Work After Severe Multiple Injuries: A Multidimensional Approach on Status 1 and 2 Years Postinjury

Soberg, Helene Lundgaard MSc; Finset, Arnstein PhD; Bautz-Holter, Erik MD, PhD; Sandvik, Leiv PhD; Roise, Olav MD, PhD

Journal of Trauma-Injury Infection & Critical Care: February 2007 - Volume 62 - Issue 2 - pp 471-481
doi: 10.1097/TA.0b013e31802e95f4
Original Articles

Background: The assessment of factors associated with return to work (RTW) after multiple trauma is important in trauma research. Goals in rehabilitation should comprise RTW. The purpose of this study was to examine the RTW rate and which factors predicted RTW for patients with severe multiple injuries using a prospective cohort design.

Methods: In all, 100 patients with a New Injury Severity Score (NISS) >15, aged 18 to 67 years and admitted to a trauma referral center, were included starting January 2002 through June 2003. Outcomes were assessed 6 weeks after discharge and 1 and 2 years postinjury. Instruments were the Brief Approach/Avoidance Coping Questionnaire, Multidimensional Health Locus of Control, Short Form-36, the World Health Organization Disability Assessment Schedule II, and a cognitive function scale (COG).

Results: Mean age was 34.5 years (SD 13.5), 83% were male, and 66% were blue-collar workers. Mean NISS was 35.1 (SD 12.7). At 1 year, 28% achieved complete RTW, 43% at 2 years. Mean time back to work was 12.8 months (SD 5.9). Differences between the RTW and not complete RTW (NRTW) groups concerned personal and demographic variables, and physical and psychosocial functioning. Survival analysis showed that risk factors for NRTW were lower education, length of stay in hospital/rehabilitation >20 weeks, and low social functioning shortly after the return home.

Conclusion: The majority of the patients had not completely returned to work 2 years postinjury. Demographic and injury related factors and social functioning were significant predictors of RTW status.

From the Faculty of Medicine, University of Oslo, Department of Physical Medicine and Rehabilitation (H.L.S., E.B.-H.), Ulleval University Hospital; the Faculty of Medicine, University of Oslo, Orthopedic Centre (O.R.), Ulleval University Hospital; Center for Clinical Research (L.S.), Ulleval Hospital; and the Department of Behavioral Sciences in Medicine (A.F.), University of Oslo, Oslo, Norway.

Submitted for publication April 17, 2006.

Accepted for publication August 16, 2006.

Funded by EXTRA funds from the Norwegian Foundation for Health and Rehabilitation.

Address for Reprints: Helene L. Soberg, MSc, Department of Physical Medicine and Rehabilitation, Ulleval University Hospital, N-0407 Oslo, Norway.

© 2007 Lippincott Williams & Wilkins, Inc.