title: Return to Work after a Stroke in Working Age Persons; A Six-Year Follow Up.
abstract: OBJECTIVE
  Stroke is one of the most common and resource intensive diseases for society. Stroke in the working age population is increasing in different parts of the world. An incomplete return to work (RTW) after sick leave post stroke entails negative consequences for the affected person and an economical burden for society. The aim of this study was to explore the RTW rate and factors associated with RTW in a six-year follow up post stroke.
  
  
  METHODS
  Data from 174 persons 63 years or younger, with first ever stroke in 2009-2010 in Gothenburg were analyzed. Baseline characteristics were collected through medical records and the Swedish Health Insurance Office provided information on sick leave up to 6 years post stroke. Time-to-event was presented and cox regression as well as logistic regression were used to analyze risk factors for no-RTW.
  
  
  RESULTS
  The RTW rate was 74.7%, at the end of follow up. Participants continued to RTW until just over 3 years post stroke. Dependency at discharge (in the modified Rankin Scale) and sick leave prior to the stroke were significant risk factors for no-RTW after 1 year with odds ratio 4.595 and 3.585, respectively. The same factors were significant in time-to-event within six years post stroke with hazard ratio 2.651 and 1.929, respectively.
  
  
  CONCLUSIONS
  RTW after a stroke is incomplete, however RTW is possible over a longer period of time than previously thought. More severe disability at discharge from hospital and sick leave prior to the stroke were shown to be risk factors for no-RTW. This knowledge can contribute to more individualized vocational rehabilitation.
authors.affiliation: Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Emma
authors.initials: E
authors.lastname: Westerlind
authors.affiliation: Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Hanna C
authors.initials: HC
authors.lastname: Persson
authors.affiliation: Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Katharina S
authors.initials: KS
authors.lastname: Sunnerhagen
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D062707:Return to Work / Q000706:statistics & numerical data*; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology*; D000071939:Stroke Rehabilitation; D013548:Sweden; D055815:Young Adult