Introduction
After burns, returning to work (RTW) is a crucial goal in rehab to restore financial stability; a sense of normality, purpose, social integration; and, quality of life. This study aimed to investigate RTW rate and identify patient-reported factors associated with not returning to work within 12 months of burn.
Methods
This retrospective cohort study included adult burn patients injured 2012–2022 who completed patient-reported outcome measures (PROMs) at 4-6 weeks and 3, 6, 12 months post-burn. PROMs assessed RTW time and work impairment outcomes: Sickness Impact Profile (SIP) and Burn-Specific Health Scale-Brief (BSHS-B). Analyses: Mixed-effects, longitudinal regression models analyzed RTW rate, work impairment, and BSHS-B work domain.
Results
Of 866 adult burn patients (21.6% state cohort), 84.6% engaged in work outside managing their home. Most were male (70.3%), median age 36.5 years (IQR: 27.0-50.0), median TBSA 2.5% (IQR: 0.8-7.0%), 83.6% required surgery and 22.5% had workplace injury. RTW rate and impairment: By 6-weeks postburn, 38% had RTW, increasing to 90% by 12-months. The mean time to return was 40 days (SD 50 days). At one-month, 79.2% reported work impairment on SIP, improving by 6 weeks to 61.3%, 55.8% (3 months), 48.4% (6 months), and 50% (12 months). Receiving more occupational therapy 1-3 months postburn was associated with reduced work impairment. Delayed RTW: Those not RTW by 1-year: longer hospital stays (12 vs 7 days, p=0.026); more surgeries (2.5 vs 1; p=0.015) but no evidence of differences in TBSA, age, or gender. Predictors of no RTW were: contact and electrical burns; non-metro residence; workplace injury; readmissions; prolonged wound healing; as well as psychology sessions in the first 6 weeks; and, OT ongoing 6-12 months post burn.
Conclusion
This PROMs-based study confirmed common non-modifiable factors were barriers, and timely multidisciplinary team input facilitated return to work, within one year after burn.