Anne Neubert (Düsseldorf / DE; Berlin / DE), Sebastian Hempe (Koblenz / DE), Carina Jaekel (Berlin / DE; Düsseldorf / DE), Dan Bieler (Koblenz / DE), Michael Bernhard (Düsseldorf / DE), Joachim Windolf (Berlin / DE; Düsseldorf / DE)
Introduction Individuals suffering from major trauma often face diverse physical, psychological, and cognitive impairments which can influence the ability to work.
Objective The aim was to systematically review factors influencing return to work (RTW) after suffering from a major trauma.
Material & Methods A search on seven databases was performed. The identified publications were selected according to the inclusion criteria: adults (≥16 years) who suffered a major trauma (Injury Severity Score (ISS) ≥16) in interventional and observational studies that explored factors associated with RTW. Risk of bias was assessed with the "Quality in Prognostic studies" tool. Due to reporting quality of the included studies no meta-analysis was performed. Data were clustered using the "International Classification of Functioning, Disability and Health" framework and qualitatively analyzed. (PROSPERO registration: CRD42022357649).
Results 12 studies with 6907 participants (mean age 45 years, 75% males, mean ISS 28) were included. The included studies had low to moderate risk of bias for most domains, only the domain "study confounding" had often a high risk of bias. Identified factors include personal factors (e.g. age, sex), body function and structure (e.g. ISS, extremity injury), environmental factors (e.g. discharge destination, time in emergency department (ED)), and activity & participation (e.g. social function, type of profession).
Conclusion Several factors appear to affect the ability to RTW after major trauma most of these (e.g. age & injury severity) do not appear to be modifiable. Yet, some may be influenced by interventions, structural or process changes such as time spend in the ED. However, the reporting quality of the included studies was insufficient to analyze the data quantitatively and as most studies did not account for confounding factors, the evidence is still uncertain. Future studies should have larger populations and better reporting quality.
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