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.

中文翻译：

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中风患者重返工作岗位的因素，趋势和长期结果：《南伦敦中风登记册》

背景和目的

关于卒中后不同时间恢复工作的因素，趋势和结果的信息有限；这项研究的目的是在多种族的城市人口中识别这些人。

方法

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

在5609名患者中，有940名（占17％）在中风前工作，其中有177名（占19％）在中风后3个月工作，在第1年时下降到172（18％），在第5年下降到113（12％）。 ，而在10年时为27（3％）。Logistic回归后，与1年内恢复工作相关的因素包括功能独立性（BI≥19; p  <0.01）和住院时间短（p  <0.05）。 脑卒中后5年和10年，年龄较小（p <0.01）与恢复工作有关。非手动职业（p <0.05）与卒中后10年恢复工作有关。在1年内恢复工作会增加在5年（OR：13.68; 95％CI 5.03–37.24）和10年（9.07; 2.07–39.8）工作的可能性。在随访中独立的患者（BI≥19）中，有48％的人在1年时工作，有42％的人在5年工作，有28％的人在10年工作。焦虑和抑郁的发生率较低，以及自我评估的健康状况较高，则与在1年后重返工作相关（p  <0.01）。

结论

尽管功能独立的卒中幸存者更可能长期恢复工作，但尽管功能独立，但仍有很大一部分人无法恢复工作。中风后恢复工作与改善长期的心理结果和生活质量有关。