Does patient cognition predict time off from work after life-threatening accidents?
OBJECTIVE
Accidental injuries are frequent and their socioeconomic consequences enormous. The present study aimed to identify predictors of the number of days of leave taken in a consecutively selected group of accident victims who sustained severe, mostly life-threatening physical trauma.


METHODS
One hundred patients with severe accidental injuries who were referred to a trauma surgeons' intensive care unit were followed up for 12 months. The main outcome measure was the number of days of leave taken that were attributable to the accident 1 year after the trauma.


RESULTS
Multiple regression analysis explained 30% of the variance in the number of days of leave taken that were attributable to the accident. Factors contributing to the predictive model were injury severity, type of accident and, most significantly, the patients' subjective self-assessment of accident severity and of their abilities to cope with the accident and its job-related consequences. Patients who perceived the severity of their accident as relatively low and judged their coping abilities as high took a mean 121 days of leave compared to 287 days of leave taken by those who perceived the trauma as relatively severe and were less optimistic regarding their coping abilities. A two-factor analysis of variance showed that patient perceptions of accident severity and their appraisal of their coping abilities made independent contributions to the predicted amount of leave taken.


CONCLUSIONS
In severely injured accident victims, leave taken because of the accident depended to a considerable degree on the patients' accident-related self-assessment.
Psychiatric Department, University Hospital, Culmannstrasse 8, 8091 Zurich, Switzerland. uschnyd@psyp.unizh.ch
Ulrich
U
Schnyder
Hanspeter
H
Moergeli
Richard
R
Klaghofer
Tom
T
Sensky
Stefan
S
Buchi
D000059:Accidents / Q000523:psychology / Q000706:statistics & numerical data*; D000062:Accidents, Occupational / Q000523:psychology / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000523:psychology / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D003071:Cognition; D004522:Educational Status; D005260:Female; D015600:Glasgow Coma Scale; D006760:Hospitalization; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D018582:Sick Leave / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*