Background and purpose
There
is limited information on factors, trends, and outcomes in return to
work at different time-points post-stroke; this
study aims to identify these in a multi-ethnic
urban population.
Methods
Patterns
of return to work were identified in individuals in paid work prior
to first-ever stroke in the population-based South
London Stroke Register (SLSR) between 1995 and
2014. Multivariable logistic regression examined
associations between patient characteristics and return to work at 1
year (1 y), 5 years (5 y) and 10 years (10 y)
post-stroke.
Results
Among
5609 patients, 940 (17%) were working prior to their stroke, of whom
177 (19%) were working 3 months post-stroke,
declining to 172 (18%) at 1 y, 113 (12%) at 5 y,
and 27 (3%) at 10 y. Factors associated with return to
work within 1 y, after logistic regression, included functional
independence (BI ≥ 19;
p < 0.01) and shorter length of stay (
p < 0.05). Younger age (
p < 0.01) was associated with return to work at 5 y and 10 y post-stroke. Non-manual occupation (
p < 0.05)
was associated with return to work at 10 y
post-stroke. Return to work within 1 y increased
the likelihood of working at 5 y (OR: 13.68; 95% CI
5.03–37.24) and 10 y (9.07; 2.07–39.8). Of those who were
independent at follow-up (BI ≥ 19), 48% were
working at 1 y, 42% at 5 y, and 28% at 10 y.
Lower rates of anxiety and depression and higher self-rated health were
associated with return to work at 1 y (
p < 0.01).
Conclusion
Although
functionally independent stroke survivors are more likely to return
to work long-term, a large proportion do not return
to work despite functional independence. Return
to work post-stroke is associated with improved
long-term psychological outcomes and quality of life.
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