title: Subjective perceptions as prognostic factors of time to fitness for work during a 4-year period after inpatient rehabilitation for orthopaedic trauma.
abstract: BACKGROUND
  Time to fitness for work (TFW) was measured as the number of days that were paid as compensation for work disability during the 4 years after discharge from the rehabilitation clinic in a population of patients hospitalised for rehabilitation after orthopaedic trauma. The aim of this study was to test whether some psychological variables can be used as potential early prognostic factors of TFW.
  
  
  METHODS
  A Cox proportional hazards model was used to estimate the associations between predictive variables and TFW. Predictors were global health, pain at hospitalisation and pain decrease during the stay (all continuous and standardised by subtracting the mean and dividing by two standard deviations), perceived severity of the trauma and expectation of a positive evolution (both binary variables).
  
  
  RESULTS
  Full data were available for 807 inpatients (660 men, 147 women). TFW was positively associated with better perceived health (hazard ratio [HR] 1.16, 95% confidence interval [CI] 1.13-1.19), pain decrease (HR 1.46, 95% CI 1.30-1.64) and expectation of a positive evolution (HR 1.50, 95% CI 1.32-1.70) and negatively associated with pain at hospitalisation (HR 0.67, 95% CI 0.59-0.76) and high perceived severity (HR 0.72, 95% CI 0.61-0.85).
  
  
  CONCLUSIONS
  The present results provide some evidence that work disability during a four-year period after rehabilitation may be predicted by prerehabilitation perceptions of general health, pain, injury severity, as well as positive expectation of evolution.
authors.affiliation: Institut de Recherche en Réadaptation, Clinique Romande de Réadaptation Suvacare, Sion, Switzerland; Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Philippe
authors.initials: P
authors.lastname: Vuistiner
authors.affiliation: Institut de Recherche en Réadaptation, Clinique Romande de Réadaptation Suvacare, Sion, Switzerland; Department of Rheumatology and Rehabilitation, Hôpital Orthopédique, Lausanne University Hospital, Lausanne, Switzerland; Department for Musculoskelet.
authors.forename: François
authors.initials: F
authors.lastname: Luthi
authors.affiliation: Department of Clinical Development, Rehaklinik Bellikon, Bellikon, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Erhart
authors.affiliation: Suva (Swiss National Accident Insurance Fund), Department of Statistics, Lucerne, Switzerland.
authors.forename: Stefan M
authors.initials: SM
authors.lastname: Scholz
authors.affiliation: Institut de Recherche en Réadaptation, Clinique Romande de Réadaptation Suvacare, Sion, Switzerland.
authors.forename: Olivier
authors.initials: O
authors.lastname: Dériaz
mesh_terms: D000328:Adult; D001007:Anxiety; D003863:Depression; D006233:Persons with Disabilities / Q000523:psychology* / Q000534:rehabilitation*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007346:Insurance, Accident; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D010146:Pain; D010147:Pain Measurement; D010809:Physical Fitness / Q000523:psychology*; D011379:Prognosis; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D062707:Return to Work; D012720:Severity of Illness Index; D013557:Switzerland