Factors Associated with Return to Work Postinjury: Can the Modified Rankin Scale Be Used to Predict Return to Work?

摘要

The ability to return to work (RTW) postinjury is one of the primary goals of rehabilitation. The modified Rankin Scale (mRS) is a validated simple scale used to assess the functional status of stroke patients during rehabilitation. We sought to determine the applicability of mRS in predicting RTW postinjury in a general trauma population. The trauma registry was queried for patients, aged 18 to 65 years, discharged from 2012 to 2013. A telephone interview for each patient included questions about employment status and physical ability to determine the mRS. Patients who had RTW postinjury were compared with those who had not (nRTW). Two hundred and thirty-four patients met the inclusion criteria. Of these, 171 (72.5%) patients RTW and 63 (26.7%) did nRTW. Patients who did nRTW were significantly older, had longer length of stay and higher rates of in-hospital complications. Multivariate analysis revealed that older patients were less likely to RTW (odds ratio 5 0.961, P 5 0.011) and patients with a modified Rankin score <=2 were 15 times more likely to RTW (odds ratio 5 14.932, P < 0.001). In conclusion, an mRS <=2 was independently associated with a high likelihood of returning to work postinjury. This is the first study that shows applicability of the mRS for predicting RTW postinjury in a trauma population. Injury can lead to devastating physical impairments that have lasting effects on a patient's ability to return to work (RTW). Postinjury RTW has often been measured as a primary outcome to assess the efficacy of comprehensive and multidisciplinary rehabilitation programs. Patients that RTW have been demonstrated to have a higher degree of life satisfaction, overall quality of life, and economic independence.3,4 Moreover, from a psychosocial standpoint, they experience decreased social isolation, reduced anxiety, as well as lower rates of substance abuse. With these outcomes in mind, being able to identify the factors that are responsible for increased RTW after injury is of paramount importance. Several studies have looked at factors predicting return to preinjury functional status and RTW. However, these studies have several limitations, in particular, they are usually injury specific and, therefore, lack broader applicability given the narrow focus of their study populations. The ability of a scoring system to predict RTW has also been previously evaluated.