Abstract
BackgroundTo determine factors predicting the duration of time away from work following acute orthopaedic non life threatening traumaMethodsProspective cohort study conducted at four hospitals in Victoria, Australia. The cohort comprised 168 patients aged 18-64 years who were working prior to the injury and sustained a range of acute unintentional orthopaedic injuries resulting in hospitalization. Baseline data was obtained by survey and medical record review. Multivariate Cox proportional hazards regression analysis was used to examine the association between potential predictors and the duration of time away from work during the six month study. The study achieved 89% follow-up.ResultsOf the 168 participants recruited to the study, 68% returned to work during the six month study. Multivariate Cox proportional hazards regression analysis identified that blue collar work, negative pain attitudes with respect to work, high initial pain intensity, injury severity, older age, initial need for surgery, the presence of co-morbid health conditions at study entry and an orthopaedic injury to more than one region were associated with extended duration away from work following the injury. Participants in receipt of compensation who reported high social functioning at two weeks were 2.58 times more likely to have returned to work than similar participants reporting low social functioning. When only those who had returned to work were considered, the participant reported reason for return to work " to fill the day" was a significant predictor of earlier RTW [RR 2.41 (95% C.I 1.35-4.30)] whereas "financial security" and "because they felt able to" did not achieve significance.ConclusionsMany injury-related and psycho social factors affect the duration of time away from work following orthopaedic injury. Some of these are potentially modifiable and may be amenable to intervention. Further consideration of the reasons provided by participants for returning to work may provide important opportunities for social marketing approaches designed to alleviate the financial and social burden associated with work disability.
Highlights
To determine factors predicting the duration of time away from work following acute orthopaedic non life threatening trauma
The aim of this study was to identify factors that influence the time to return to work (RTW) in a sample of participants, both compensated and not compensated, who had been hospitalized following acute non life threatening orthopaedic trauma resulting in a range of injuries
Information on RTW status at six months was available for 152 participants (90.4%)
Summary
To determine factors predicting the duration of time away from work following acute orthopaedic non life threatening trauma. Lessons learnt from the natural history of lower back pain are that the longer a person remains off work following injury, the higher the risk of ongoing work disability [2]. While substantial research has been directed towards musculoskeletal injuries resulting from cumulative trauma, there has been little research examining factors predicting the duration of time away from work following acute trauma. In the small number of studies that address this injury population; higher education, white collar work, high self efficacy and strong social support were associated with earlier RTW while the receipt of compensation and the presence of depression or post traumatic stress were associated with extended time off work [7,8,9].
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