Stroke location is not associated with return to work after first ischemic stroke.
OBJECTIVE
In prior studies, age, race, job category, disability, and cortical functions such as praxis, language, and memory have been associated with vocational outcome, but the influence of stroke location on return to work has never been critically examined.


METHODS
We examined the influence of stroke location on vocational outcome in patients with clinically confirmed acute ischemic stroke from the National Institute of Neurological Disorders and Stroke Stroke Data Bank.


RESULTS
Of 143 patients working full time at the time of first ischemic stroke, 23 patients were dead and 120 were alive at 1 year. Employment status was known in 109 (mean age, 55 years; 51 [47%] were white, and 82 [75%] were male). Fifty-eight (53%) had returned to work; most (85%) worked full time. Younger age was positively associated with return to work (P<0.05). In an age-adjusted analysis, stroke severity as measured by the Barthel Index 7 to 10 days after stroke was negatively associated with return to work (P<0.001). Higher household income and absence of cortical neurological dysfunction 7 to 10 days after stroke were positively but less strongly associated with return to work (P<0.08). Stroke location, sex, and depression at time of stroke were not associated with vocational outcome.


CONCLUSIONS
Our data suggest that stroke location may be less important than other more easily measured factors in predicting vocational outcome.
Wozniak
M A
MA
Departments of Neurology, University of Maryland School of Medicine, Baltimore 21201, USA. mwozniak@som.umaryland.edu
Kittner
S J
SJ
Price
T R
TR
Hebel
J R
JR
Sloan
M A
MA
Gardner
J F
JF
D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D001037:Aphasia / Q000209:etiology; D002540:Cerebral Cortex / Q000473:pathology; D002560:Cerebrovascular Circulation; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D020243:Infarction, Anterior Cerebral Artery / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D020762:Infarction, Posterior Cerebral Artery / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D020521:Stroke / Q000150:complications / Q000473:pathology* / Q000503:physiopathology