Proportion of Non-severe Ischemic Stroke Patients Returning to Work

Abstract

OBJECTIVE To explore the proportion of non-severe ischemic stroke patients returning to work (RTW) and to examine the association of demographic, clinical, and evaluative information with RTW outcomes. METHODS This observational study included non-severe ischemic stroke patients at the stroke ward, Srinagarind Hospital, Khon Kaen, Thailand between September 2021 and November 2022. Patients included were over 18-year-old, had NIHSS scores not exceeding 14, were currently employed and wanted to RTW. Patients were assessed at the discharged time, 2-week-follow-up, and 3-month-follow-up. Bivariate analysis was conducted using either Chi-square or Fisher’s exact test. RESULTS Sixty-four patients were recruited of whom 4 dropped out, leaving a total of 60. The cumulative proportions of successful RTW patients at the discharged time, 2-week-follow-up, 1-month-follow-up, and 3-month-follow-up were 26.7%, 51.7%, 70%, and 76.7% (95%CI 16.8-38.8, 39.2-64.0, 57.7-80.5, 64.9-86.0), respectively. Most patients could RTW in the first month, then the number plateaued at 3 months. More successful RTW patients included those in cognitive demand occupations, evaluated as normal to minor neurological severity, motor power graded 4-5 at discharge, passed MoCA or MMSE test, and who were rated as independent by either the mRS or the BI. Bivariate analysis revealed statistically significant association between RTW proportion and occupation type, neurological severity, motor power, and ADL disability. CONCLUSIONS Most non-severe ischemic stroke patients could RTW within 3 months after discharge. Occupational type, neurological severi-ty, motor power, and ADL associated with the proportion of RTW (3-month-follow-up). RTW evaluation of non-severe stroke patients should be assessed at short intervals for 3 months after discharge. KEYWORDS return to work, ischemic stroke, occupation, cognition, activities of daily living