Factors Predictive of Return to Work After Stroke in Patients With Mild-Moderate Disability in India

Abstract

Background: Successful return to work after stroke may improve economic circumstances, quality of life, and overall life satisfaction but not everyone is able to return to work.

Aims: To determine what proportion of previously employed patients return to work after an acute stroke with mild to moderate disability and examine factors associated with successful return to work.

Methods: Patient interviews and chart review collected information and assessed anxiety, depression and social support using previously validated instruments with previously employed patients with a first-ever stroke 3 months to 2 years prior, aged 18-60. Multivariate logistic regression assessed factors associated with successful return to work.

Results: 52.5% of 141 patients (mean age 48 ± 8.8), returned to work after stroke. Analysis demonstrated a lower modified Rankin scale at 3 months (OR 2.68, 95% CI 1.08-6.02), younger age (OR 2.26, 95% CI 1.04–4.89), and professional or business jobs (OR 2.61, 95% CI 1.6 - 5.97) were significantly associated with successful return to work. Anxiety, depression and social support score did not affect patients’ decision to return to work (p=0.30, 0.37, 0.27 respectively)

Conclusions: Among patients with mild to moderate disability after stroke, almost half do not return to work. Functional disability and type of job rather than psychosocial factors such as anxiety and depression were most important.