RETURN TO WORK FOLLOWING INJURY - THE ROLE OF ECONOMIC, SOCIAL, AND JOB-RELATED FACTORS

Objectives. This study examined factors influencing return to work (RT W) following severe fracture to a lower extremity. Methods. This prosp ective cohort study followed 312 individuals treated for a lower extre mity fracture at 3 level-1 trauma centers. Kaplan-Meier estimates of t he proportion of RTW were computed, and a Cox proportional hazards mod el was used to examine the contribution of multiple risk factors on RT W. Results. Cumulative proportions of RTW at 3, 6, 9, and 12 months po stinjury were 0.26, 0.49, 0.60, and 0.72. After accounting for the ext ent of impairment, characteristics of the patient that correlated with higher rates of RTW included younger age, higher education, higher in come, the presence of strong social support, and employment in a white -collar job that was not physically demanding. Receipt of disability c ompensation had a strong negative effect on RTW! Conclusions. Despite relatively high rates of recovery, one quarter of persons with lower e xtremity fractures did not return to work by the end of 1 year. The an alysis points to subgroups of individuals who are at high risk of dela yed RTW, with implications for interventions at the patient, employer, and policy levels.