Objective

To identify socio-occupational and medical factors associated with non-return to work 3 years after severe road-accident injury.

Materials/Patients and methods

ESPARR is a prospective 5-year cohort of 1168 road-accident victims, aged over 16 years, in the Rhône administrative Département of France. 141 (63.5%) of the 222 subjects with severe injury (maximal abbreviated Injury Scale >= 3) in work at the time of the accident reported whether they had returned to work during the 3 years following the accident. Two groups were distinguished: those who had returned to work during the 3 years ( n = 113; 79.1%) and those who had not ( n = 28; 19.9%). The groups were compared on socio-occupational and accident-related medical factors at 3 years post-accident, by univariate analysis on Chi ² or Fisher test, and multivariate analysis on a generalized linear model.

Results

Being separated, widowed or divorced at the time of the accident, initial head, face and lower-limb lesion severity, New injury severity score ³ 16, onset of post-traumatic stress disorder, persistence of intense pain and perceived poor quality of life and health status at 3 years post-accident emerged as factors associated with non-return to work on univariate analysis. On multivariate analysis, severity of initial head lesions, persistence of intense pain at 3 years and onset of post-traumatic stress disorder remained significant factors for non-return to work 3 years after severe road-accident injury.

Discussion/Conclusion

Chronic pain and post-traumatic stress disorder appeared in this study to be the main factors on which action could be taken. Early adapted treatment of these factors could facilitate return to work in victims of severe injury.