Predictors of return to work after stroke: a prospective, observational cohort study with 6 months follow-up

Abstract

Purpose

To determine, in Brazil, the proportion of individuals who return to a paid work after stroke, and the factors which predict this.

Materials and methods

A prospective observational cohort study was carried out for six months. Participants were recruited early after stroke from four public hospitals. The outcome of interest was return to work, and the following predictors were investigated: age, sex, education, marital status, contribution to household income, type of work, independence, and depression. Logistic regression was used to identify multivariate predictors of return to work.

Results

Of the 117 included participants, 52 (44%) had returned to work by 6 months. Contribution to household income (OR 2.4; 95% CI 1.0 to 5.9), being a white-collar worker (OR 4.0; 95% CI 1.8 to 8.6) and being independent in daily activities at 3 months (OR 10.6; 95% CI 2.9 to 38.3), in combination, positively predicted return to work.

Conclusions

Less than 50% of stroke survivors returned to work six months after stroke. Among predictors, only the level of dependence in daily activities is a modifiable factor. Interventions aimed at reducing disability after stroke might increase rates of return to work.

Implications for rehabilitation

• In Brazil, less than 50% of stroke survivors returned to work six months after stroke.

• Clinicians may collect information regarding household income, type of work and dependence in daily activities to estimate chances of returning to work, in developing countries.

• Being independent at 3 months was the strongest predictor of return to work; therefore, interventions aimed at reducing disability after stroke may increase rates of return to work.

Keywords:

• Stroke
• work
• employment
• activities of daily living
• disability
• rehabilitation

Data availability

The data that support the findings of this study are available from the corresponding author (LRN), upon reasonable request.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Financial support for this research was provided by the Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPq – 406400/2017–2, and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brazil (CAPES) – Finance Code 001.