Determinants of work absence following surgery for carpal tunnel syndrome.
BACKGROUND
The objective was to identify factors across multiple domains associated with return to work in a community-based cohort of workers with carpal tunnel syndrome.


METHODS
Workers scheduled for carpal tunnel release were recruited into this prospective study. Subjects completed questionnaires preoperatively and at 2, 6, and 12 months postoperatively. The questionnaires contained demographic, clinical, and psychosocial factors and physical and psychosocial workplace stressors. Predictors of work absence at 6 and 12 months were examined in bivariate and multivariate logistic regression analyses.


RESULTS
Six months following surgery of 181 subjects, 29 (19%) were out of work. Twelve months postoperatively 33 subjects (22%) were out of work. In bivariate analyses, the factors associated with work absence at 6 months, at P < or = 0.01, included preoperative physical functional status, change in self-efficacy between preoperative assessment and 2 months, lower income, workers' compensation, representation by an attorney, work exposure to force and repetition, higher psychological job demands and lower control, lower social support by coworkers, lower job security and more supportive organizational policies and practices. The factors associated with work absence at 12 months in bivariate analyses included preoperative physical functional status, lower self-efficacy at 2 months, workers' compensation, and less supportive organizational policies and practices. Multivariate analyses documented a multidimensional model, with predictors from multiple domains.


CONCLUSIONS
Clinical, demographic, economic, and workplace factors were associated with work absence. Strategies to reduce work absence following carpal tunnel release should address multiple dimensions of the worker and workplace.
Katz
Jeffrey N
JN
Robert Brigham Arthritis and Musculoskeletal Clinical Research Center, Section of Clinical Sciences, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. Jnkatz@partners.org
Amick
Benjamin C
BC
Keller
Robert
R
Fossel
Anne H
AH
Ossman
Janet
J
Soucie
Valerie
V
Losina
Elena
E
D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000601:surgery*; D018582:Sick Leave / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors