Returning to Work is Associated with Higher Quality of Life: A LIMB-Q Analysis in Patients with Limb-Threatening Injuries.

Objectives: To identify clinical, demographic, and patient-reported outcomes (PROs) associated with return to work after lower extremity traumatic injury requiring amputation or limb salvage.

Methods: Design: Cross-sectional study.

Setting: Multi-center across 25 countries.

Patient selection criteria: Working patients who sustained lower extremity trauma requiring soft-tissue reconstruction or amputation.

Outcome measures and comparisons: The main outcome measurements were LIMB-Q scores. Regression analyses were performed to evaluate associations between functional and quality of life outcomes by return to work status.

Results: Responses were received from 258 participants with 66% males (n=173) and a mean age of 40 years old (IQR: 19-78) . Of respondents that worked prior to injury, 67% (n=173) returned to work after a mean 16 months (SD 39). Divorced or widowed status [p=0.006; OR 0.107 (95% CI 0.022-0.531)], bilateral injuries [p=0.004; OR 0.093 (95% CI 0.019-0.471)], and having a manual labor job [p=0.002; OR 0.191 (95% CI 0.027-0.395)] were negatively associated with return to work. Increased time since injury [p=0.036, OR 1.08 (95% 1.02, 1.16)] and higher educational status [p=0.024; OR 5.12 (95% CI 1.24, 21.0)] were positively associated with return to work status. Reconstruction or amputation was not associated with return to work [p=0.087, OR (95% CI 0.190-1.11)]. LIMB-Q Function (p=0.033; 95% CI [-11.3, -0.49]), and LIMB-Q Life Impact (p=0.008; 95% CI [-13.5, -2.01]) scores were significantly increased in patients that returned to work after injury.

Conclusions: Patients who returned to work after lower extremity injury reported higher levels of function and overall return to normalcy in their lives. Returning to work may improve quality of life in patients following lower extremity trauma.

Level of evidence: Prognostic Level III.