Predictors of return to work after traumatic injury: Associations of employment with long-term patient-reported outcomes

Background

After traumatic injury, patients face significant physical, psychosocial, and economic barriers to recovery. In this study, we evaluate return to work as an indicator of holistic recovery and hypothesized that patients with stronger baseline social support would be more likely to be employed at follow-up.

Methods

From October 2019 - July 2024, we prospectively collected data on employment, social support and Patient-Reported Outcomes Measurement Information System-29 domains (depression, anxiety, physical function, sleep disturbance, fatigue, ability to participate in social roles, pain intensity, and pain interference in daily activity) for adult trauma patients admitted to an urban, academic, level-1 trauma center. Participants were screened at the time of injury and had at least 1 follow-up at 6 or 12 months. Injury characteristics were collected from the institutional trauma registry. Using multivariate logistic regression analysis, we assessed relationships between follow-up employment status, baseline social support, and follow-up Patient-Reported Outcomes Measurement Information System-29 domains.

Results

Complete data were available for 310 patients, with 175 patients employed at baseline. In total, 54.2% of these patients reported return to work at 6- or 12-month follow-up. No significant differences were identified between employment and social support at baseline, 6- or 12-month follow-up. In multivariable analysis, employment was associated with better pain intensity scores (odds ratio, 0.77 [0.65–0.92], P = .003) and physical function (odds ratio, 0.30 [0.12–0.75], P = .01)

Conclusion

Post-injury return to employment was not associated with social support. However better patient-reported outcomes were associated with return to employment. Employment may be an important marker of recovery after injury and a pathway to economic stability and social recovery.