Return to work after stroke: development of a predictive model.
Seventy-nine stroke patients who underwent a vocationally oriented, comprehensive, inpatient stroke rehabilitation program were followed up to evaluate their return to work. At follow-up, 49% had returned to work a mean of 3.1 months after rehabilitation discharge. Factors associated with success and with failure of vocational rehabilitation were then identified, and a predictive model was developed. There were positive associations between return to work and Barthel Index on admission (p = 0.0002) and discharge (p = 0.0015). Negative associations were found between return to work and aphasia (p = 0.0009), rehabilitation length of stay (p less than 0.0001), and prior alcohol consumption (p = 0.03). A step-wise multiple regression model explained 42% of the variance in return to work. Those most likely to return to work were not aphasic; they had shorter rehabilitation lengths of stay and higher Barthel Index scores on discharge; and they were lighter consumers of alcoholic beverages before their strokes. In conclusion, a set of factors predictive of return to work in younger stroke patients was identified, including, most notably, a strong negative association with aphasia and an intriguing negative association with prior alcohol consumption.
Black-Schaffer
R M
RM
Young Stroke Unit, New England Rehabilitation Hospital, Woburn, MA 01801.
Osberg
J S
JS
D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking; D001037:Aphasia / Q000534:rehabilitation; D002561:Cerebrovascular Disorders / Q000534:rehabilitation*; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012050:Rehabilitation, Vocational; D012737:Sex Factors; D011795:Surveys and Questionnaires