Predictive Factors for Return to Work After a First Stroke Treated at Clermont-Ferrand University Hospital in Puy de Dôme Between January 2020 and December 2024

Stroke is a leading cause of acquired motor disability and the second most common cause of major cognitive impairment worldwide. In France, approximately 150,000 new cases occur annually, with around 31% affecting individuals of working age, making return to work (RTW) a critical public health issue. Beyond the medical burden, stroke has profound socio-economic consequences, including loss of productivity, prolonged sick leave, part-time resumption, and the need for workplace adaptations. While RTW after stroke has been investigated, major gaps remain. No standardized recommendations exist for vocational reintegration, and predictive factors are still debated. Quantitative determinants such as stroke type, severity, functional independence, and occupational characteristics have been identified, but qualitative aspects-including self-efficacy, perceived social burden, employer relationships, and motivation-are poorly documented. Moreover, cognitive deficits are often insufficiently characterized, as screening tools such as MMSE or MoCA lack the sensitivity of comprehensive neuropsychological assessments. The impact of revascularization procedures on RTW and the ability to sustain employment after initial resumption also remain unclear. Importantly, no recent data are available in the Auvergne region, despite evolving labor policies that may influence reintegration trajectories. This observational study therefore aims to identify both quantitative and qualitative predictors of RTW after ischemic or hemorrhagic stroke, describe vocational pathways in a regional cohort, and explore barriers and facilitators to long-term reintegration. Ultimately, the study seeks to provide updated evidence to guide tailored rehabilitation and socio-professional reintegration strategies, supporting sustainable RTW in working-age stroke survivors.