Trajectories and predictors of return to work after traumatic limb injury - a 2-year follow-up study

Objectives This study aims to explore the trajectories of return to work (RTW) and examine the predictors of different trajectories among workers following traumatic limb injury. Methods A total of 804 participants were recruited during hospital admission for a 2-year prospective study. The RTW outcome was repeatedly assessed at 1, 3, 6, 12, 18, and 24 months after the injury. A group-based trajectory model (GBTM) was employed to identify trajectories of RTW among the participants. Comparisons of group characteristics of different trajectories were performed based on a multinomial logistic regression. Results GBTM identified three distinct trajectories of RTW: (i) fast RTW consisted of workers with early and stable RTW status from the first month after the injury; (ii) average RTW consisted of workers who achieved and remained at a stable RTW status within 6 months; and (iii) slow RTW consisted of workers who had slow and unsustainable RTW status within the 2-year follow-up period. The estimated proportions were 21.5%, 50.7%, and 27.8%, respectively. Workers with slow and unsustainable RTW after injury were found to be older, married, less educated, employed as repair personnel/operators/laborers, seriously injured, and depressed; they were also found to feel more disturbance in daily life, have lower self-efficacy, and believe they experience a poorer quality of life. Conclusion Following traumatic limb injury, individual workers showed three distinct RTW trajectories, each of which was associated with different categories of biopsychosocial factors. An understanding of how different factors contribute to increasing the likelihood of RTW for injured workers in each trajectory group should aid policy-making in worker-oriented vocational rehabilitation programs.