Factors influencing return to work after stroke in Japan.

The assessment of the literature on sick-leave with cardiovascular diseases include only studies with sufficient scientific quality. These studies describe sick leave following stroke, myocardial infarction, coronary artery bypass grafting (CABG), or percutaneous coronary intervention (PCI). We found limited scientific evidence for the following results: After stroke, more than half of the patients of working age returned to work (RTW) during the first year following onset (higher rate for the younger patients). The consequences of brain damage, e.g. impaired ADL ability or cognitive capacity, play an important role in this respect. Also after myocardial infarction most patients RTW. PCI is a milder coronary artery intervention than CABG and RTW is more rapid. However, in the long run there are no differences in sick leave. People at higher ages or with physically demanding jobs return to work to a lesser degree. An international comparison shows that the duration of sick leave due to these conditions in Sweden is longer than in other countries although there is no scientific evidence to support this practice. It appears that the interest in research on sick leave in patients with cardiovascular diseases has waned in recent years. Developments in acute cardiological care should inspire renewed scientific involvement in this area of research.

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“…In studies that included SAH (6,8,10), e.g. stroke, the results point in the same direction as in these four studies.…”

Section: Results Group A: Subarachnoid and Intracerebral Haemorrhagessupporting

confidence: 66%

“…Predictors for not returning to work include high age, female gender, stroke in the left cerebral hemisphere, greater level of hemiplegia, lower functional level (ADL) and impaired cognitive capacity. Other such factors include low educational level and limited possibilities for adapting the workplace (10). Depression is common (9).…”

Section: Evidencementioning

confidence: 99%

Chapter 8. Sick leave due to coronary artery disease or stroke

Perk

Alexanderson

2004

Scand J Public Health

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“…This proportion is consistent with the results of other studies worldwide 7,8,9 ; however, ours was the first study looking at RTW in India among patients with mild to moderate disability. Our study revealed that professional or business employment, lower mRS scores 3 months post stroke, and younger age were associated with a successful RTW.…”

Section: Section Iv: Discussion Limitations and Future Directionssupporting

confidence: 92%

“…As expected, functional disability is a major determinant in one's decision and ability to RTW. [8][9][10][11][12] . A lower level of functional disability at stroke onset and a lower level of functional disability at 3 months were significantly associated with a successful return to work in our study.…”

Section: Section Iv: Discussion Limitations and Future Directionsmentioning

confidence: 99%

Factors predictive of return to work after stroke in patients with mild−moderate disability in India

Bonner

Pillai

Sarma

et al. 2015

Euro J of Neurology

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Background Successful return to work after stroke may improve economic circumstances, quality of life and overall life satisfaction, but not all stroke survivors are able to return to work. Aim Our aim was to determine what proportion of previously employed patients return to work after an acute stroke resulting in mild to moderate disability and to examine factors associated with a successful return to work. Methods Patients 18–60 years of age who were previously employed and who had a first‐ever stroke 3 months to 2 years previously resulting in mild to moderate disability (modified Rankin score ≤3) were recruited. Socio‐demographic and clinical information was collected and anxiety, depression and social support were assessed using previously validated instruments. Multivariate logistic regression was used to assess factors associated with a successful return to work. Results Of 141 patients (mean age ± SD 48 ± 8.8 years), 74 (52.5%) returned to work after stroke. Multivariate analysis demonstrated that a lower modified Rankin scale at 3 months [odds ratio (OR) 3.70, 95% confidence interval (CI) 1.77–7.76], younger age (OR 2.24, 95% CI 1.07–4.67) and a professional or business job (OR 3.02, 95% CI 1.44–6.34) were significantly associated with successful return to work and revealed that anxiety, depression and social support score did not affect patients' decision to return to work (P = 0.17, 0.61 and 0.27, respectively). Conclusions Amongst patients with mild to moderate disability after stroke, almost half do not return to work, and this is determined by functional disability and type of job rather than psychosocial factors such as anxiety and depression.

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“…3 Few studies have attempted to explore the factors influencing return to work after stroke. [7][8][9][10] Demographic factors such as age, race, and socioeconomic characteristics have been associated with vocational outcome. These studies have identified specific cortical signs such as apraxia 9 as important predictors of return to work after stroke.…”

mentioning

confidence: 99%

Stroke Location Is Not Associated With Return to Work After First Ischemic Stroke

Wozniak

Kittner

Price

et al. 1999

Stroke

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Background and Purpose-In prior studies, age, race, job category, disability, and cortical functions such as praxis, language, and memory have been associated with vocational outcome, but the influence of stroke location on return to work has never been critically examined. Methods-We examined the influence of stroke location on vocational outcome in patients with clinically confirmed acute ischemic stroke from the National Institute of Neurological Disorders and Stroke Stroke Data Bank. Results-Of 143 patients working full time at the time of first ischemic stroke, 23 patients were dead and 120 were alive at 1 year. Employment status was known in 109 (mean age, 55 years; 51 [47%] were white, and 82 [75%] were male). Fifty-eight (53%) had returned to work; most (85%) worked full time. Younger age was positively associated with return to work (PϽ0.05). In an age-adjusted analysis, stroke severity as measured by the Barthel Index 7 to 10 days after stroke was negatively associated with return to work (PϽ0.001). Higher household income and absence of cortical neurological dysfunction 7 to 10 days after stroke were positively but less strongly associated with return to work (PϽ0.08). Stroke location, sex, and depression at time of stroke were not associated with vocational outcome. Conclusions-Our data suggest that stroke location may be less important than other more easily measured factors in predicting vocational outcome. (Stroke. 1999;30:2568-2573.)

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Factors influencing return to work after stroke in Japan.

Cited by 54 publications

References 14 publications

Chapter 8. Sick leave due to coronary artery disease or stroke

Chapter 8. Sick leave due to coronary artery disease or stroke

Factors predictive of return to work after stroke in patients with mild−moderate disability in India

Stroke Location Is Not Associated With Return to Work After First Ischemic Stroke

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