Neurological and Mental Health Division, The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia.
PLoS One. 2012;7(7):e41795. doi: 10.1371/journal.pone.0041795. Epub 2012 Jul 25.
To determine which early modifiable factors are associated with younger stroke survivors' ability to return to paid work in a cohort study with 12-months of follow-up conducted in 20 stroke units in the Stroke Services NSW clinical network.
Were aged >17 and <65 years, recent (within 28 days) stroke, able to speak English sufficiently to respond to study questions, and able to provide written informed consent. Participants with language or cognitive impairment were eligible to participate if their proxy provided consent and completed assessments on the participants' behalf. The main outcome measure was return to paid work during the 12 months following stroke.
Of 441 consented participants (average age 52 years, 68% male, 83% with ischemic stroke), 218 were in paid full-time and 53 in paid part-time work immediately before their stroke, of whom 202 (75%) returned to paid part- or full-time work within 12 months. Being male, female without a prior activity restricting illness, younger, independent in activities of daily living (ADL) at 28 days after stroke, and having private health insurance was associated with return to paid work, following adjustment for other illnesses and a history of depression before stroke (C statistic 0·81). Work stress and post stroke depression showed no such independent association.
Given that independence in ADL is the strongest predictor of return to paid work within 12 months of stroke, these data reinforce the importance of reducing stroke-related disability and increasing independence for younger stroke survivors.
Australian New Zealand Clinical Trials Registry ANZCTRN 12608000459325.
在新南威尔士州卒中服务临床网络的 20 个卒中单元中开展了一项队列研究，对其中 12 个月的随访结果进行分析，以确定哪些早期可改变因素与年轻卒中幸存者在卒中后能够重返有偿工作相关。
年龄>17 岁且<65 岁，近期（<28 天）卒中，能够用足够的英语回答研究问题，并且能够提供书面知情同意。如果有语言或认知障碍的参与者的代理人同意并代表其完成评估，则符合参与条件。主要结局指标为卒中后 12 个月内重返有偿工作。
在 441 名同意参与的患者中（平均年龄 52 岁，68%为男性，83%为缺血性卒中），卒中前有 218 人从事全职有偿工作，53 人从事兼职有偿工作，其中 202 人（75%）在 12 个月内重返兼职或全职有偿工作。在调整了其他疾病和卒中前的抑郁病史后，男性、女性且无既往活动受限疾病、年龄较小、卒中后 28 天日常生活活动自理能力独立，以及拥有私人医疗保险与重返有偿工作相关（C 统计量 0.81）。工作压力和卒中后抑郁与重返有偿工作无独立相关性。
鉴于日常生活活动自理能力是卒中后 12 个月内重返有偿工作的最强预测因素，这些数据强化了减少卒中相关残疾和提高年轻卒中幸存者独立性的重要性。
澳大利亚新西兰临床试验注册中心 ANZCTRN 12608000459325。
