Prediction of time to return to work after gynaecological surgery: a prospective cohort study in the Netherlands

A. Vonk Noordegraaf, J.R. Anema, M.D. Louwerse, M.W. Heijmans, W. van Mechelen, H.A.M. Brölmann, J.A.F. Huirne

Research output: Contribution to JournalArticleAcademicpeer-review


Objective: To measure the impact of the level of invasiveness of gynaecological procedures on time to full Return to Work (RTW) and to identify the most important preoperative sociodemographic, medical and work-related factors that predict the risk of prolonged sick leave. Design: Prospective cohort study. Setting: Dutch university hospital. Population: A total of 148 women aged 18-65 years scheduled for gynaecological surgery for benign indications. Methods: A questionnaire regarding the surgical procedure as well as perioperative and postoperative complications was completed by the attending resident at baseline and 6 weeks after surgery. All other outcome measures were assessed using self-reported patient questionnaires at baseline and 12 weeks post-surgery. The follow-up period was extended up to 1 year after surgery in women failing to return to work. Surgical procedures were categorised into diagnostic, minor, intermediate and major surgery. Main outcome measures: Time to RTW and important predictors for prolonged sick leave after surgery. Results: Median time to RTW was 7 days (interquartile range [IQR] 5-14) for diagnostic surgery, 14 days (IQR 9-28) for minor surgery, 60 days (IQR 28-101) for intermediate surgery and 69 days (IQR 56-135) for major surgery. Multivariable analysis showed a strongest predictive value of RTW 1 year after surgery for level of invasiveness of surgery (minor surgery hazard ratio [HR] 0.51, 95% CI 0.32-0.81; intermediate surgery HR 0.20, 95% CI 0.12-0.34; major surgery HR 0.09, 95% CI 0.06-0.16), RTW expectations before surgery (HR 0.55, 95% CI 0.36-0.84), and preoperative functional status (HR 1.09, 95% CI 1.04-1.13). A prediction model regarding the probability of prolonged sick leave at 6 weeks was developed, with a sensitivity of 89% and a specificity of 86%. Conclusions: RTW often takes a long time, especially after intermediate and major surgery. This study reveals important predictors for prolonged sick leave and provides a prediction model for the risk of sick leave extending 6 weeks after benign gynaecological surgery in the Netherlands. © 2013 Royal College of Obstetricians and Gynaecologists.
Original languageEnglish
Pages (from-to)487-497
JournalBJOG: An International Journal of Obstetrics & Gynaecology
Issue number4
Publication statusPublished - 2014


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