Return to work 10 years after severe trauma.

backgroundSevere trauma continues to pose a substantial burden on survivors, particularly in terms of long-term physical, psychological, and social functioning. While survival rates have improved, data on long-term outcomes remain limited. This study evaluates ten-year post-injury outcomes in patients with major trauma, focusing on return to work and social participation.

methodsIn this single-center, retrospective cohort study, adult patients (≥ 18 years) with an Injury Severity Score (ISS) ≥ 9 treated between 2010 and 2013 were surveyed and distributed minimally 10 years later. Patients completed standardized questionnaires assessing sociodemographic and occupational data, functional status, and psychological well-being using the Trauma Outcome Profile (TOP).

resultsNinety-one patients completed the follow-up. The mean age at injury was 43.0 years, with a mean ISS of 20.8. Ten years post-trauma, 82.4% of patients had returned to work; 10.6% required vocational retraining, and 25.3% changed occupations. Failure to return to work was significantly associated with higher ISS (p = 0.027), increased anxiety (p = 0.005), post-traumatic stress disorder (PTSD, p = 0.039), and reduced mental functioning (p = 0.009), but not with physical functioning ten years after the trauma. Patients with mental health impairments were more likely to experience reduced independence, impaired social participation, and difficulties in activities of daily living.

conclusionA majority of patients successfully reintegrated into the workforce ten years after trauma. Mental health, rather than physical disability, emerged as the primary determinant of long-term occupational reintegration. These findings underscore the necessity for comprehensive, long-term rehabilitation programs that prioritize psychosocial support.