Prognostic factors in short-term disability due to musculoskeletal disorders.
OBJECTIVE
To identify factors associated with poor outcome in temporary work disability (TWD) due to musculoskeletal disorders (MSDs).


METHODS
We conducted a secondary data analysis of a 2-year randomized controlled trial in which all patients with TWD due to MSDs in 3 health districts of Madrid (Spain) were included. Analyses refer to the patients in the intervention group. Primary outcome variables were duration of TWD and recurrence. Diagnoses, sociodemographic, work-related administrative, and occupational factors were analyzed by Cox proportional hazards models.


RESULTS
We studied 3,311 patients with 4,424 TWD episodes. The following were independently associated with slower return to work: age (hazard ratio [HR] 0.99, 95% confidence interval [95% CI] 0.98-0.99), female sex (HR 0.84, 95% CI 0.78-0.90), married (HR 0.90, 95% CI 0.83-0.97), peripheral osteoarthritis (HR 0.77, 95% CI 0.6-0.9), sciatica (HR 0.59, 95% CI 0.54-0.65), self-employment (HR 0.56, 95% CI 0.48-0.65), unemployment (HR 0.41, 95% CI 0.28-0.58), manual worker (HR 0.86, 95% CI 0.79-0.94), and work position covered during sick leave (HR 0.84, 95% CI 0.77-0.92). The factors that better predicted recurrence were peripheral osteoarthritis (HR 1.75, 95% CI 1.14-2.6), inflammatory diseases (HR 1.66, 95% CI 1.009-2.72), sciatica (HR 1.30, 95% CI 1.08-1.56), indefinite work contract (HR 1.43, 95% CI 1.14-1.75), frequent kneeling (HR 1.39, 95% CI 1.15-1.69), manual worker (HR 1.19, 95% CI 1.003-1.42), and duration of previous episodes (HR 1.003, 95% CI 1.001-1.005).


CONCLUSIONS
Sociodemographic, work-related administrative factors, diagnosis, and, to a lesser extent, occupational factors may explain the duration and recurrence of TWD related to MSD.
Abásolo
Lydia
L
Hospital Clínico San Carlos, Madrid, Spain.
Carmona
Loreto
L
Lajas
Cristina
C
Candelas
Gloria
G
Blanco
Margarita
M
Loza
Estibaliz
E
Hernández-García
César
C
Jover
Juan A
JA
D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D009140:Musculoskeletal Diseases; D011379:Prognosis; D018582:Sick Leave / Q000706:statistics & numerical data*; D013997:Time Factors