Factors associated with return to work after ischemic stroke in young adults in Northwest China: a retrospective study

@article{geng2026factors,
  title = {{Factors associated with return to work after ischemic stroke in young adults in Northwest China: a retrospective study}},
  author = {Yufei Geng and Wangyang Zeng and Zihan Su and Kexin Yuan and Zepeng Tian and Ting You and Jianfeng Han and Suhang Shang and Simeng Cui and Hui Liu and Yi Qi and Jia Yu and Ying Tan and Chen Chen and Baibing Mi and Yan Qv and Yingying Zhao and Xi Chen and Suixia Cao and Qingqing Zhou},
  journal = {Journal of Stroke and Cerebrovascular Diseases},
  year = {2026},
  month = nov,
  doi = {10.1016/j.jstrokecerebrovasdis.2026.108779},
  url = {https://doi.org/10.1016/j.jstrokecerebrovasdis.2026.108779},
  note = {CC BY},
}

TY  - JOUR
TI  - Factors associated with return to work after ischemic stroke in young adults in Northwest China: a retrospective study
AU  - Yufei Geng
AU  - Wangyang Zeng
AU  - Zihan Su
AU  - Kexin Yuan
AU  - Zepeng Tian
AU  - Ting You
AU  - Jianfeng Han
AU  - Suhang Shang
AU  - Simeng Cui
AU  - Hui Liu
AU  - Yi Qi
AU  - Jia Yu
AU  - Ying Tan
AU  - Chen Chen
AU  - Baibing Mi
AU  - Yan Qv
AU  - Yingying Zhao
AU  - Xi Chen
AU  - Suixia Cao
AU  - Qingqing Zhou
PY  - 2026
DA  - 2026/11/03
JO  - Journal of Stroke and Cerebrovascular Diseases
DO  - 10.1016/j.jstrokecerebrovasdis.2026.108779
UR  - https://doi.org/10.1016/j.jstrokecerebrovasdis.2026.108779
AB  - Background: Stroke increasingly affects working-age individuals. Returning to work (RTW) is a critical rehabilitation goal for these patients. This study investigated the proportion of young adults in Northwest China who did not return to work (NRTW) 12 months after an ischemic stroke and identified factors associated with NRTW. Methods: We conducted a retrospective analysis of young patients (18-49 years) with ischemic stroke, admitted between January 2017 to August 2019, who had stable employment before onset. Data collected included demographics, lifestyle, comorbidities, stroke etiology classification, clinical features (including NIHSS score and specific functional impairments at admission) and medical interventions. RTW status was determined at the 12-month follow-up. Missing data were handled using multiple imputation by chained equations (20 imputed datasets). Univariable and multivariable logistic regressions were applied to identify factors associated with NRTW. Results: Among 339 previously employed patients (median age 44; 284 [83.78%] males), 106 (31.3%) had not returned to work at 12 months. Multivariable analysis identified female (OR = 3.02, 95% CI 1.21–7.52, P = 0.017) and pre-stroke manual labor (OR = 4.66, 95% CI 2.50–8.66, P < 0.001) as significant demographic factors positively associated with NRTW. A higher NIHSS score at admission was associated with NRTW (NIHSS 5–9 vs. 0–4: OR = 3.12, 95% CI 1.46–6.69, P = 0.003; NIHSS ≥ 10 vs. 0–4: OR = 6.69, 95% CI 2.35–19.04, P < 0.001). Regarding specific impairments, aphasia was significantly associated with NRTW (OR = 3.67, 95% CI 1.32–10.20, P = 0.013), while motor dysfunction showed a marginal positive association (OR = 1.83, 95% CI 0.99–3.35, P = 0.052). Cardioembolic stroke showed significant association in the model including specific clinical features (OR = 4.12, 95% CI 1.36–12.46, P = 0.012, Model 2), a finding that requires confirmation in larger studies. Conclusion: A proportion of young stroke survivors in Northwest China do not resume work at 12 months after stroke. Key factors associated with failure to RTW include female sex, pre-stroke manual labor, greater stroke severity (higher NIHSS), and the presence of aphasia. Motor dysfunction may also be an important factor in RTW. The association of stroke etiology with RTW may be influenced by neurological severity. These findings highlight the need for targeted interventions to improve RTW outcomes in this population.
SN  - 1532-8511
ER  -