Factors predicting employment 1 year after traumatic spine fracture

Study Design. This prospective cohort study evaluates the employment status of 489 persons after traumatic spine fracture. Objectives. To determine the rate, type, and predictors of employment 1 year after traumatic spine fracture. Summary of Background Data. The limited existing literature regarding employment after spine fracture reports variable return-to-work rates, tends to be retrospective, and generally evaluates a limited number of predictor factors at a time. Methods. Four hundred eighty-nine persons ranging in age from 15 to 64 years who had experienced a spine fracture were assessed by a single examiner at hospital discharge and 1 year postinjury. Employment status and type, discharge neural and functional status, pain level, demographics, injury fever and severity, and early treatment details were evaluated. Results. At 1 year postinjury, 54% of subjects were working. A higher percentage of the employed were working part time and for fewer weeks per year than preinjury. A higher percentage were working at unskilled clerical, sales, or service jobs than preinjury. The significant positive (+) and negative (-) predictors of employment were (from strongest to weakest): worked in year previous to injury (+); employed at time of injury (+); Worker's Compensation Board coverage (-); spinal fracture surgery (+); high-level spine fracture (-); pain (-); Functional Independence Measure score (+); and days of stay in intensive care unit and spinal unit (-). Conclusions. for the first year after spinal fracture, unemployment is common. Those who do return to work are more likely to modify the amount and type of work they do and to have been employed preinjury.