Predictors of Return to Work Following Major Trauma in New Zealand

OBJECTIVE: This study aimed to identify physical and psychological predictors of return to work (RTW) in a cohort of major trauma patients in New Zealand. METHODS: A retrospective cohort study was conducted at Christchurch Hospital involving patients identified from the New Zealand Major Trauma Registry. Full-time workers (n = 130) who sustained major trauma between 2016 and 2020 completed self-reported questionnaires assessing post-injury work capacity, PTSD (PCL-5), anxiety and depression (HADS) and perceived social support (MSPSS). Univariable and multivariable analyses were performed to determine predictors of decreased RTW following injury. RESULTS: Older age, longer hospital length of stay (LOS) and ICU admission were all significantly associated with decreased RTW in the univariable analysis. Probable anxiety and depression were also significantly associated with decreased RTW, while meeting PTSD thresholds did not yield a significant association. In the final multivariable analysis, older age (OR 1.08, p < 0.01), longer LOS (OR 1.04, p = 0.048) and those with probable depression (OR 5.29, p = 0.01) were significantly associated with decreased RTW. CONCLUSIONS: Probable depression is a strong, independent psychological predictor of reduced RTW following major trauma. These findings highlight the need for integrated post-trauma care models that incorporate routine psychological screening and early intervention to address both the physical and psychological needs of patients suffering from major trauma.