Research Fellow Department of Neurological Surgery, New York Presbyterian Hospital/Och Spine, Weill Cornell Medicine, New York, New York.
Introduction: Employment and its sustainability is a priority for many patients following spine trauma, as it is associated with numerous health, psychosocial and financial benefits, including better quality of life. Little is known about the factors affecting post-injury employment in low- and middle-income nations. This study highlights the employment rate after spine trauma and associated sociodemographic and clinical characteristics in East Africa.
Methods: This was a telephone-based survey utilizing a prospectively maintained spine trauma database at Muhimbili Orthopedic Institute (MOI). Four hundred fifty patients managed at MOI for TSI between September 2016 and October 2021 were eligible. Sociodemographic data, injury characteristics, employment status before the injury, and complications were collected. The outcome measure was employment after injury. Simple logistic regression was used to assess the association between independent variables and outcome measures. Statistical analysis was conducted using R studio.
Results: One hundred thirty patients completed the interview. The median age at injury was 33 years, and most were male (87.7%). The median length of follow-up and time since injury were 31.4 and 33 months, respectively. Most patients were married (65.4%) and had primary education only (54.6%). 86.9% reported having a complication post-discharge. 61.5% were employed before the injury, but only 40% had employment after the injury. Patients were more likely to be employed post-injury if they were married/cohabiting (OR=5.23; 95% CI 2.20, 13.99 p< 0.001), had higher education (OR=3.22; 95% CI 1.39, 7.79 p=0.007), employed before injury (OR 86.17; 95% CI 17.41, 1565.71 p< 0.001), and had insurance (OR 2.96 95%CI 1.27 7.18 p=0.009). Patients were less likely to be employed after injury if they reported any complications (OR 0.23 95%CI 0.06 0.66 p=0.014), had complete injuries (OR 0.35 95%CI 0.14 0.80 p=0.017), and reported access to wheelchairs (OR 0.24 95%CI 0.11 0.52 p< 0.001).
Conclusion : Our research identifies several variables that are associated with employment following spinal trauma. The results of the current study can help target resources to subsets of the spine trauma population that need greater aid or intervention to improve their chances of finding employment, such as through vocational rehabilitation services or programs.
