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Does Grit Predict Return to Work After Upper Extremity Surgery? A Prospective Observational Study
Elizabeth Cho, MD
1, Klea Gjonaj, BS
2, Daniel Walsh, MD
1; Sahitya K. Denduluri, MD
1(1)Loyola University Medical Center, Maywood, IL, (2)Loyola University Stritch School of Medicine, Maywood, IL
Introduction:
Psychological resilience traits such as grit-the perseverance and passion for long-term goals-are increasingly recognized as influential in postoperative recovery. This study primarily aimed to assess whether higher grit scores were associated with faster return to work (RTW) following carpal tunnel release (CTR) surgery. Secondary objectives included evaluating the influence of patient-reported outcome measures (PROMs) as well as other clinical factors on RTW after CTR.
Methods:This was prospective cohort study of patients who underwent isolated CTR at a single academic institution between 2023 and 2024. Grit was measured preoperatively using the Short Grit Scale. RTW was defined as the number of days between CTR and earliest documented return to either limited or full duty. Patient-reported outcome measures (PROMs) included PROMIS Global Health and QuickDASH scores which were obtained at both the preoperative and 3 months minimum postoperative interval. Patients were excluded if they did not work, did not have documented RTW dates, and/or did not complete the Grit Scale or PROMs. Spearman correlation coefficients were calculated to assess bivariate associations. Multivariable linear regression was used to identify independent predictors of time to RTW while adjusting for grit, PROM scores, age, and whether the dominant hand was treated.
Results:Among 28 patients included with an average age of 49 years (range 26-67), the mean grit score was 3.72 (SD 0.51), and the median time to RTW was 26 days (range 5-153). Spearman rank correlation indicated a moderate and statistically significant association (? = 0.42,
p = 0.034), suggesting patients with higher grit scores returned to work later. Greater preoperative disability on QuickDASH (? = 0.42,
p = 0.032) and older age (? = 0.66,
p < 0.001) were also associated with longer RTW. PROMIS Global Health scores (Physical and Mental summary scores) were not significantly correlated with RTW. On multivariable regression, only age remained a statistically significant independent predictor of RTW time (
p = 0.031). Grit score, QuickDASH, and dominant hand involvement were not significant when adjusting for covariates.
Conclusion:Contrary to expectations, higher grit scores were associated with delayed return to work after CTR on univariate analysis, possibly reflecting more cautious recovery behavior. However, only patient age independently predicted delayed RTW on multivariate regression. Further research is needed to understand how psychological traits such as grit influence recovery behaviors and decisions post-CTR.
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