Background: Loss of employment contributes significantly to the burden of stroke on individuals and society. There is limited information on factors influencing return to work after stroke.
Objectives: To investigate frequency and determinants of return to paid work after stroke in a multiethnic urban population.
Methods: Patterns of return to work were examined among people with first-ever stroke registered in the population-based South London Stroke Register (SLSR). Employment status and functional outcome (Barthel Index, BI; Frenchay Activity Index, FAI) were assessed one year after stroke. Associations between baseline characteristics and return to paid work were analysed by multivariable logistic regression analysis.
Results: Among 2874 patients with first-ever strokes in 1995-2004, 400 (15%) were working before stroke. At 1 year, 94 (35%) of 266 survivors had returned to paid work. Black ethnicity (odds ratio, 0.41; 95% CI, 0.19-0.88), female sex (0.43; 0.21-0.91), older age (p<0.001), diabetes (0.25; 0.08-0.79), and dependence (BI≤19) in the acute phase (0.24; 0.11-0.49) were independently associated with lower odds of return to work in multivariable analysis. Better functional outcome at 1 year was associated with return to paid work (p<0.001), but 53% of 161 independent (BI>19) and 39% of 96 very active (FAI>30/45) individuals had not resumed work.
Conclusions: There were important sociodemographic differences in return to work after stroke that were independent of clinical and service use variables included in the analysis. A large proportion of patients did not resume work despite excellent functional outcome.