Predictors of return to work following traumatic work-related lower extremity amputation.
OBJECTIVE
To determine factors predictive of return to work (RTW) and days of total disability (TD) in a population of persons working at the time of lower extremity amputation.


METHODS
Retrospective chart and database review.


RESULTS
Of 88 valid cases, 48% involved toe amputation, 23% transtibial, 14% partial foot, 14% transfemoral, and 2% high level. Fifty-eight percent of all subjects RTW, 19% were deemed 'fit for work', and 23% did not RTW. Days TD ranged from 0 to 1664, with a mean of 366 days. Toe amputation level showed a mean of 127 days of TD. Bivariate analysis showed amputation level, total costs to Workers Compensation Board (WCB), and days TD significantly related to RTW, and rehabilitation costs, vocational rehabilitation, work assessment, age, number of surgical procedures, number of days in acute care, and amputation level significantly related to days TD. In the multivariate model, only amputation level and higher gross annual income showed predictive value for RTW. However older age, more surgical procedures, less days in hospital, and higher amputation levels were all predictive of increased days TD.


CONCLUSIONS
Toe amputation level had a surprisingly high number of days TD, which may have significant potential economic and disability impact on the workplace. Other factors beyond simply amputation level (such as previous income level) are important considerations for RTW.
Hebert
Jackie S
JS
Division of Physical Medicine and Rehabilitation, University of Alberta, Glenrose Rehabilitation Hospital Site, 10230 - 111 Avenue, Edmonton, Alberta, Canada, T5G 0B7. jhebert@cha.ab.ca
Ashworth
Nigel L
NL
D000062:Accidents, Occupational; D000293:Adolescent; D000328:Adult; D000368:Aged; D000416:Alberta; D000673:Amputation, Traumatic / Q000175:diagnosis / Q000534:rehabilitation*; D004185:Disability Evaluation; D004651:Employment; D005260:Female; D006801:Humans; D016014:Linear Models; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D014942:Workers' Compensation / Q000706:statistics & numerical data