Determinants of return to work following non life threatening acute orthopaedic trauma: a prospective cohort study.

Abstract

OBJECTIVE: To determine factors associated with return to work following acute non-life-threatening orthopaedic trauma. DESIGN: Prospective cohort study. PARTICIPANTS: One hundred and sixty-eight participants were recruited and followed for 6 months. The study achieved 89% participant follow-up. METHODS: Baseline data were obtained by survey and medical record review. Participants were further surveyed at 2 weeks, 3 and 6 months post-injury. Logistic regression was used to examine the association between potential predictors and first return to work by these 3 time-points. RESULTS: Sixty-eight percent of participants returned to work within 6 months. Those who sustained isolated upper extremity injuries were more likely to return to work early. Significant positive determinants of return to work included a strong belief in recovery, the presence of an isolated injury, education to university level and self-employment. Determinants associated with non-return to work included the receipt of compensation, older age, pain attitudes and blue-collar work. The primary reason given for return to work was financial security. CONCLUSION: Demographic, injury, occupation and psychosocial factors were significant predictors of return to work. The relative importance of factors at different time-points suggests that return to work is a multifactorial process that involves the complex interaction of many factors in a time-dependent manner.