Introduction

Displaced fractures in the sacrum are associated with other intra-pelvic organ injuries. There are some reports on short term outcome, however there is little knowledge about the long-term morbidity after these severe injuries.

Background: The assessment of factors associated with return to work (RTW/NRTW) after multiple trauma is important in trauma research. Goals in rehabilitation should comprise RTW. The purpose of this study was to examine the RTW rate and which factors that predicted RTW for patients with severe multiple injuries using a prospective cohort design.

Methods: 100 patients with a New Injury Severity Score (NISS) > 15, age 18–67 admitted to a Level I trauma center were included starting January 2002 through June 2003. Outcomes were assessed 6 weeks after discharge, 1 and 2 years post-injury. Instruments were the Brief Approach/Avoidance Coping Questionnaire, Multi-dimensional Health Locus of Control, SF-36, the WHODAS II and the COG for cognitive functioning.

Results: Mean age was 34.5 years (SD 13.5), 83% were male. Mean NISS was 35.1 (SD 12.7). 66% were blue-collar workers. At 1 year 29% achieved complete RTW, 43% at 2 years. Mean time back to work was 12.8 months (SD 5.9). Differences between the RTW/ NRTW groups concerned personal and demographic variables, and physical and psychosocial functioning. Survival analysis showed that risk factors for NRTW were lower education, length of stay in hospital/rehabilitation > 20 weeks and low social functioning shortly after the return home.

Conclusions: The majority of the patients had not completely returned to work 2 years post-injury. Demographic and injury related factors and social functioning were significant predictors of RTW status.