A Prospective Study of Factors Influencing Return to Work After Traumatic Spinal Cord Injury in Taiwan

Objective: To examine comprehensively the effects of physical, psychologic, and sociologic characteristics on employment among persons after a traumatic spinal cord injury (SCI) in Taiwan. Design: A prospective study with follow-up telephone interviews over a 3-year period. Setting: To register people who had sustained an SCI, medical records of 4 hospitals were reviewed using codes of the International Classification of Diseases-9th Revision-Clinical Modifications from 806.0 to 806.9 and from 952.0 to 952.9. Participants: Subjects (N=219) employed at the time of injury. Interventions: Not applicable. Main Outcome Measures: Employment status after an SCI. Results: The employment rate was 32.9%. After controlling for other variables, education level (relative rate [RR]=4.01 similar to 8.17), autonomy in transportation (RR=5.13), professional licensure (RR=1.86), and thrill and adventure-seeking trait (RR=1.12) were positively and significantly associated with employment, while subjects with more severe overall injury severity (RR=0.95), preinjury chronic conditions (RR=0.20), necessity for aids for daily living (RR=0.31), and depression (RR=0.38) were less likely to have been employed than their counterparts. Conclusions: In addition to education level and traditional physical factors, overall injury severity and psychologic factors such as thrill and adventure seeking and depression can also influence the return to work after an SCI.