Factors associated with return-to-work and health outcomes among survivors of road crashes in Victoria

Objective: To explore the relationships between injury, disability, work role and return-to-work outcomes following admission to hospital as a consequence of injury sustained In a road crash. Design and setting: Prospective cohort study of patients admitted to an adult trauma centre and two metropolitan teaching hospitals in Victoria, Australia. Participants were interviewed in hospital, 2.5 and eight months post-discharge. Participants: Participants were 60 employed and healthy adults aged 18 to 59 years admitted to hospital in the period February 2004 to March 2005. Results: Despite differences in health between the lower extremity fracture and non-fracture groups eight months postcrash the proportions having returned to work was approximately 90%. Of those returning to work, 44% did so in a different role. After adjustment for baseline parameters, lower extremity injuries were associated with a slower rate of return to work (HR: 0.31; 95%Cl: 0.16-0.58) as was holding a manual occupation (HR: 0.16; 95%Cl: 0.09-0.57). There were marked differences in physical health between and within the injury groups at both follow-up periods. Conclusions: These results demonstrate that both injury type and severity and the nature of ones occupation have a considerable influence on the rate and pattern of return to work following injury. Further, persisting disability has a direct influence on the likelihood of returning to work. The implications of these findings and the types of data required to measure outcome post-injury are discussed.