title: Are work return and leaves of absence predictable after an unstable pelvic ring injury?
abstract: BACKGROUND
  Resuming work after surgical treatment of an unstable pelvic ring injury is often impeded because of residual disability. The aim of this study was to test which factors influence return to work, ability to return to the same job function as before the injury, leaves of absence, and incapacitation after sustaining a pelvic fracture.
  
  
  METHODS
  We performed a retrospective study on patients with surgically treated pelvic fractures. Medical records were reviewed to document patients' demographic data, the extent of follow-up care, diagnosis of the injury (according to the Tile system of classification), type of surgical treatment, injury severity, and the time from trauma to definitive surgery. We also recorded the classification of patients' physical status according to the American Society of Anesthesiologists (ASA) and details about admission to the intensive care unit (ICU). Patients were interviewed to note the number of days before returning to work and their ability to maintain their previously held jobs.
  
  
  RESULTS
  Fifty patients were included in the study, and their mean age was 46.3 ± 12.6 years. The median time to return to work was 195 days. Twelve patients (24 %) lost their jobs and 17 (34 %) resumed their previous job with a change of tasks. ICU admission and time from trauma to definitive surgery were negatively correlated with return to the previously held job. Returning to the same job tasks was not associated with any of the factors investigated. Polytrauma, ICU admission, and time from trauma to definitive surgery were associated with longer leaves of absence.
  
  
  CONCLUSIONS
  Work reintegration after pelvic ring injuries is a major issue for patients and health care systems: 58 % of patients were not able to return to or lost their job. Factors correlated with leaves of absence were injury severity, delayed definitive fixation, and ICU admission.
  
  
  METHODS
  IV (case series).
authors.affiliation: Medical School, University of Turin, Turin, Italy. ale_aprato@hotmail.com.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Aprato
authors.affiliation: Clinical Investigation and Documentation (C.I.D.) Department, AO Foundation, Dübendorf, Switzerland.
authors.forename: Alexander
authors.initials: A
authors.lastname: Joeris
authors.affiliation: Medical School, University of Turin, Turin, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Tosto
authors.affiliation: Clinical Investigation and Documentation (C.I.D.) Department, AO Foundation, Dübendorf, Switzerland.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Kalampoki
authors.affiliation: Clinical Investigation and Documentation (C.I.D.) Department, AO Foundation, Dübendorf, Switzerland.
authors.forename: Elke
authors.initials: E
authors.lastname: Rometsch
authors.affiliation: Medical School, University of Turin, Turin, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Favuto
authors.affiliation: Medical School, University of Turin, Turin, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Stucchi
authors.affiliation: Manoel Victorino Hospital, Salvador, Brazil.
authors.forename: Matheus
authors.initials: M
authors.lastname: Azi
authors.affiliation: Medical School, University of Turin, Turin, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Massè
mesh_terms: D000041:Absenteeism; D004185:Disability Evaluation; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D010384:Pelvic Bones / Q000293:injuries* / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D062707:Return to Work; D012307:Risk Factors; D013997:Time Factors
keywords: Leave of absence; Morbidity; Pelvic fracture; Pelvic ring injuries; Productivity loss