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Predictors of return to work following motor vehicle related orthopaedic trauma.

Murgatroyd DF, Harris IA, Tran Y, Cameron ID, Murgatroyd D - BMC Musculoskelet Disord (2016)

Bottom Line: Of 452 study participants 334 (74%) were working pre-injury: results are based on this subset.Legal representation (analysed at six months only) was not associated with time to RTW.A longer time to RTW was associated with greater injury severity and lower occupational skill levels; while a shorter time to RTW was associated with recovery expectations for usual activities within 90 days, full-time pre-injury work hours, and very good self-assessed pre-injury health status.

View Article: PubMed Central - PubMed

Affiliation: John Walsh Centre for Rehabilitation Research, The University of Sydney, Kolling Institute, Sydney, NSW, Australia.

ABSTRACT

Background: Work disability following motor vehicle related orthopaedic trauma is a significant contributor to the burden of injury and disease. Early identification of predictors for return to work (RTW) is essential for developing effective interventions to prevent work disability. The study aim was to determine the predictors (including compensation related factors) of time to RTW following motor vehicle related orthopaedic trauma.

Methods: Admitted patients were recruited prospectively from two trauma hospitals with upper and/or lower extremity fractures following a motor vehicle crash. Baseline and follow up data were collected by written questionnaire. For baseline, this occurred in person within 2 weeks of injury. For follow up, this occurred by mail at six, 12 and 24 months. Additional demographic and injury-related information was retrieved from hospital databases. Analysis involved: descriptive statistics; logrank test to detect survival distributions of categorical variables; and Cox proportional hazards regression models for risks of time to RTW using baseline characteristic and compensation related variables (at 6 months).

Results: Of 452 study participants 334 (74%) were working pre-injury: results are based on this subset. Baseline characteristics were mean age 36 years (13.9 Standard Deviation [SD]), 80% male; 72% self-assessed very good-excellent pre-injury health, 83% household income > AU$40,000 (Australian Dollar). Follow up data was available for 233 (70%), 210 (63%), and 182 (54%) participants at six, 12 and 24 months respectively. Significant risks of a longer time to RTW were greater injury severity, as measured by the New Injury Severity Score (NISS) (Hazards Rate Ratio [HRR] = 0.54, 95% CI 0.35-0.82); and lower occupational skill levels (HRR = 0.53, 95% CI 0.34-0.83). Significant risks of a shorter time to RTW were: recovery expectations for usual activities within 90 days (HRR = 2.10, 95% CI 1.49-2.95); full-time pre-injury work hours (HRR = 1.99, 95% CI 1.26-3.14); and very good self-assessed pre-injury health status (HRR = 1.41, 95% CI 0.98-2.02). Legal representation (analysed at six months only) was not associated with time to RTW. At each time period, there were 146 (63%), 149 (71%), and 137 (76%) working participants.

Conclusions: A longer time to RTW was associated with greater injury severity and lower occupational skill levels; while a shorter time to RTW was associated with recovery expectations for usual activities within 90 days, full-time pre-injury work hours, and very good self-assessed pre-injury health status. Our findings reinforce existing research. There is an opportunity to trial interventions that address potentially modifiable factors. The issues surrounding legal representation are complex and require further research.

No MeSH data available.


Related in: MedlinePlus

Flow chart of study participants
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Fig1: Flow chart of study participants

Mentions: From November 2007 to February 2011, 840 eligible participants were admitted to hospital across both sites, 491 were screened (349 eligible participants missed being screened due to resource limitations), and 452 (92 %) consented to participate. There were 31 refusals and eight who were discharged and unable to be contacted. Additional information about recruitment and follow up for study participants is shown in Fig. 1. There were significant differences (p < 0.05) in baseline characteristics, namely socio-demographic and socio-economic factors, between those working and not working pre-injury. These differences were expected and people not working were not included in the analyses (data not shown). Of the 452 participants, our subsequent results are based on the subset of 334 (74 %) participants who worked up to the time of injury.Fig. 1


Predictors of return to work following motor vehicle related orthopaedic trauma.

Murgatroyd DF, Harris IA, Tran Y, Cameron ID, Murgatroyd D - BMC Musculoskelet Disord (2016)

Flow chart of study participants
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4837506&req=5

Fig1: Flow chart of study participants
Mentions: From November 2007 to February 2011, 840 eligible participants were admitted to hospital across both sites, 491 were screened (349 eligible participants missed being screened due to resource limitations), and 452 (92 %) consented to participate. There were 31 refusals and eight who were discharged and unable to be contacted. Additional information about recruitment and follow up for study participants is shown in Fig. 1. There were significant differences (p < 0.05) in baseline characteristics, namely socio-demographic and socio-economic factors, between those working and not working pre-injury. These differences were expected and people not working were not included in the analyses (data not shown). Of the 452 participants, our subsequent results are based on the subset of 334 (74 %) participants who worked up to the time of injury.Fig. 1

Bottom Line: Of 452 study participants 334 (74%) were working pre-injury: results are based on this subset.Legal representation (analysed at six months only) was not associated with time to RTW.A longer time to RTW was associated with greater injury severity and lower occupational skill levels; while a shorter time to RTW was associated with recovery expectations for usual activities within 90 days, full-time pre-injury work hours, and very good self-assessed pre-injury health status.

View Article: PubMed Central - PubMed

Affiliation: John Walsh Centre for Rehabilitation Research, The University of Sydney, Kolling Institute, Sydney, NSW, Australia.

ABSTRACT

Background: Work disability following motor vehicle related orthopaedic trauma is a significant contributor to the burden of injury and disease. Early identification of predictors for return to work (RTW) is essential for developing effective interventions to prevent work disability. The study aim was to determine the predictors (including compensation related factors) of time to RTW following motor vehicle related orthopaedic trauma.

Methods: Admitted patients were recruited prospectively from two trauma hospitals with upper and/or lower extremity fractures following a motor vehicle crash. Baseline and follow up data were collected by written questionnaire. For baseline, this occurred in person within 2 weeks of injury. For follow up, this occurred by mail at six, 12 and 24 months. Additional demographic and injury-related information was retrieved from hospital databases. Analysis involved: descriptive statistics; logrank test to detect survival distributions of categorical variables; and Cox proportional hazards regression models for risks of time to RTW using baseline characteristic and compensation related variables (at 6 months).

Results: Of 452 study participants 334 (74%) were working pre-injury: results are based on this subset. Baseline characteristics were mean age 36 years (13.9 Standard Deviation [SD]), 80% male; 72% self-assessed very good-excellent pre-injury health, 83% household income > AU$40,000 (Australian Dollar). Follow up data was available for 233 (70%), 210 (63%), and 182 (54%) participants at six, 12 and 24 months respectively. Significant risks of a longer time to RTW were greater injury severity, as measured by the New Injury Severity Score (NISS) (Hazards Rate Ratio [HRR] = 0.54, 95% CI 0.35-0.82); and lower occupational skill levels (HRR = 0.53, 95% CI 0.34-0.83). Significant risks of a shorter time to RTW were: recovery expectations for usual activities within 90 days (HRR = 2.10, 95% CI 1.49-2.95); full-time pre-injury work hours (HRR = 1.99, 95% CI 1.26-3.14); and very good self-assessed pre-injury health status (HRR = 1.41, 95% CI 0.98-2.02). Legal representation (analysed at six months only) was not associated with time to RTW. At each time period, there were 146 (63%), 149 (71%), and 137 (76%) working participants.

Conclusions: A longer time to RTW was associated with greater injury severity and lower occupational skill levels; while a shorter time to RTW was associated with recovery expectations for usual activities within 90 days, full-time pre-injury work hours, and very good self-assessed pre-injury health status. Our findings reinforce existing research. There is an opportunity to trial interventions that address potentially modifiable factors. The issues surrounding legal representation are complex and require further research.

No MeSH data available.


Related in: MedlinePlus