Return to work of major trauma survivors from a private level 1 trauma centre in South Africa.

Purpose: Trauma is known as a leading cause of mortality and injury related disability globally. In South Africa (SA) the socioeconomic burden of trauma is magnified as the working age is most affected. The aim of this study was to describe the proportion of major trauma survivors who returned to work (RTW) during a 6-month period post hospital discharge and to identify the factors associated with the RTW outcome.

Methods: This was a prospective observational cohort study involving major trauma survivors from a private level 1 trauma centre intensive care unit in SA between January and September 2022. RTW status was assessed using the Employment Questionnaire. Univariate and multivariable Cox proportional hazards regression was used in analysis.

Results: Sixty-four of the 86 participants (74.4%) RTW at six months post hospital discharge. RTW had a median time of 16 weeks. After adjusting and backwards analysis, Chelsea Critical Care Physical assessment tool scores (adjusted hazard ratio (AHR), 1.06, 95% CI 1.01-1.10, p = 0.007), and not having applied/received any form of grants (AHR 2.26, 95% CI 1.35-3.77, p = 0.002) were the only factors that were associated with the RTW outcome.

Conclusion: The cumulative probability of no RTW was 25.6% among participants after 24 weeks. Higher physical function at ICU discharge and not seeking any form of compensation was associated with a higher probability of RTW. This study has highlighted the complexities of RTW and the socioeconomic burden following major trauma. There is therefore a need for further studies on RTW following major trauma in SA.