title: Occurrence and predictors of employment after traumatic spinal cord injury: the GISEM Study.
abstract: METHODS
  Multicenter, prospective study.
  
  
  OBJECTIVE
  To assess the occurrence and predictors of return to work after traumatic spinal cord injury (SCI).
  
  
  METHODS
  Italian rehabilitation centers.
  
  
  METHODS
  We evaluated patients previously included in the Italian Group for the Epidemiological Study of Spinal Cord Injuries study. A standardised telephone interview was used to collect data after a mean follow-up of 3.8 years. The main outcome measure was employment at the end of follow-up.
  
  
  RESULTS
  A total of 403 patients, 336 men and 67 women, with a mean age of 41.8±16.3 years, were included in the follow-up. In all, 42.1% of patients were employed at the moment of the interview, though 62% reported a worsening in their employment level. Predictors of employment were education (P<0.0001), bowel continence (P=0.02), independence in mobility (P=0.0004), ability to drive (P<0.0001), participating in the community (P=0.0001) and ability to live alone (P<0.0001) while age (P<0.0001), being married (P<0.0001), tetraplegia (P=0.03), occurrence of recent medical problems (P=0.002), re-hospitalization (P=0.02), presence of architectonic barriers (P=0.009) and having a public welfare subsidy (P<0.0001), predicted unemployment. On the basis of multivariate analysis, younger age, education, absence of tetraplegia, ability to drive, ability to live alone, previous employment were independent predictors of employment after SCI. Employment at follow-up was related to several indicators of quality of life.
  
  
  CONCLUSIONS
  Employment after SCI was rather frequent and was related to several patient characteristics and social factors. Specific interventions on the patient and on the social environment may favor employment after SCI and improve quality of life.
authors: Department of Rehabilitation, IRCSS San Raffaele Pisana, Rome, Italy. marco.franceschini@sanraffaele.it
authors: M
authors: M
authors: Franceschini
authors: M C
authors: MC
authors: Pagliacci
authors: T
authors: T
authors: Russo
authors: G
authors: G
authors: Felzani
authors: S
authors: S
authors: Aito
authors: C
authors: C
authors: Marini
mesh_terms: D000328:Adult; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012111:Residence Characteristics; D013119:Spinal Cord Injuries / Q000191:economics / Q000523:psychology / Q000534:rehabilitation; D055815:Young Adult