Determinants of early return to work after first stroke in Japan.

OBJECTIVE To examine the time to return to work after first stroke and identify determinants of early return to work in Japan. DESIGN A multicentre, prospective cohort study on the association between characteristics at admission and early return to work after first stroke. SUBJECTS Among 464 patients after first stroke, 325 were registered in this study. All participants were younger than 65 years and engaged in paid work at the time of the stroke. METHODS Data collected prospectively for 18 months were analysed using the Kaplan-Meier method for time trends, and then a multiple logistic regression model for odds ratio of early to late return to work was conducted. RESULTS Of the 325 registered patients (mean age 55.1, standard deviation (SD) 7.4 years), 253 (78%) were available for follow-up, and 138 (55%) returned to work. The curve of proportion of return to work was non-linear. Significant determinants of early return to work were gender, function of hemiplegic hand, and ability to perform activities of daily living independently. CONCLUSION The curve of time to return to work was influenced by the follow-up days. Patients after stroke who were male and/or had milder physical disabilities tended to return to work earlier.