Abstract
Study design:
Multicenter, prospective study.
Objectives:
To assess the occurrence and predictors of return to work after traumatic spinal cord injury (SCI).
Setting:
Italian rehabilitation centers.
Methods:
We evaluated patients previously included in the Italian Group for the Epidemiological Study of Spinal Cord Injuries study. A standardised telephone interview was used to collect data after a mean follow-up of 3.8 years. The main outcome measure was employment at the end of follow-up.
Results:
A total of 403 patients, 336 men and 67 women, with a mean age of 41.8±16.3 years, were included in the follow-up. In all, 42.1% of patients were employed at the moment of the interview, though 62% reported a worsening in their employment level. Predictors of employment were education (P<0.0001), bowel continence (P=0.02), independence in mobility (P=0.0004), ability to drive (P<0.0001), participating in the community (P=0.0001) and ability to live alone (P<0.0001) while age (P<0.0001), being married (P<0.0001), tetraplegia (P=0.03), occurrence of recent medical problems (P=0.002), re-hospitalization (P=0.02), presence of architectonic barriers (P=0.009) and having a public welfare subsidy (P<0.0001), predicted unemployment. On the basis of multivariate analysis, younger age, education, absence of tetraplegia, ability to drive, ability to live alone, previous employment were independent predictors of employment after SCI. Employment at follow-up was related to several indicators of quality of life.
Conclusion:
Employment after SCI was rather frequent and was related to several patient characteristics and social factors. Specific interventions on the patient and on the social environment may favor employment after SCI and improve quality of life.
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Appendix
Appendix
The GISEM group included the following investigators and centers: Ceravolo MG, Clinica di Neuroriabilitazione, Ancona; Nardulli R, Centro Medico Cassano Murge - IRCCS, Cassano Murge; Aito S, Unità Spinale CTO, Firenze; Cellotto N, Centro Riabilitazione ‘Villa Beretta’, Costamasnaga; Zucchi AG, Sezione Mielolesi, Magenta; Manera C, Unità Spinale Unipolare Osp. Niguarda, Milano; Bava A, Divisione Paraplegici CTO, Milano; Ghislandi I, SRRF Ospedale di Bergamo – Sez. Mozzo, Mozzo; Ortolani M, Servizio di Riabilitazione Ortopedica, Padova; Taricco MA, Ospedale Casati, Passirana di Rho; Pistarini C, Centro Medico Montescano, Pavia; Mosetti A, Ospedale Villa Rosa - CRF, Pergine Valsugana; Pagliacci MC, Unità Spinale Unipolare Osp. Silvestrini, Perugia; Gatta G, SRRF Ospedale S. M. delle Croci, Ravenna; Scivoletto G, IRCCS Santa Lucia, Roma; Trigila A, Unità Spinale Unipolare CTO, Roma; Occhi E, Unità Spinale, Sondalo; Loria D, Unità Spinale, Torino; Zampolini M, U.O. di Riabilitazione Intensiva Neuromotoria, Trevi; Di Benedetto P, Centro di Riabilitazione, Trieste; Cordioli Z, Reparto di RRF Ospedale Sacro Cuore - Don Calabria - Negrar, Verona; Leucci M, UORRF Unità Spinale Osp. S. Bartolo, Vicenza; Lotta S, Centro di R.R.F., Villanova d'Arda; Strazzabosco C, Istituto Riabilitazione Neuromotoria, Mezzaselva di Roana.
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Franceschini, M., Pagliacci, M., Russo, T. et al. Occurrence and predictors of employment after traumatic spinal cord injury: the GISEM Study. Spinal Cord 50, 238–242 (2012). https://doi.org/10.1038/sc.2011.131
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DOI: https://doi.org/10.1038/sc.2011.131
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