Sickness Absence following Coronary Revascularisation. A National Study of Women and Men of Working Age in Sweden 1994–2006

Abstract

BackgroundEvidence based and gender specific knowledge about sickness absence following coronary revascularisation is lacking. The objective was to investigate sickness absence after a first coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) among women and men in a national Swedish study.Materials and MethodsAll patients 30–63 years of age, who underwent a first CABG (n = 22,985, 16% women) or PCI (40,891, 22% women) in Sweden between 1994 and 2006 were included. Information on sickness absence, co-morbidity, and other patient characteristics was obtained from national registers. Long-term sickness absence (LTSA) was defined as >180 and >90 sick-leave days in the first sick-leave spell following CABG and PCI, respectively. Prevalence ratio (PR) and 95% confidence interval (CI) of LTSA were calculated.FindingsLTSA followed the interventions in 41% and 36% for CABG and PCI patients, respectively. Women had more often LTSA compared with men, (CABG PR = 1.23: 95% CI 1.19–1.28 and PCI PR = 1.19; 95% CI 1.16–1.23). A history of sickness absence the year before the intervention increased the risk for LTSA after the intervention in both genders. Among women, older age, or being self employed or unemployed was associated with a lower risk for LTSA. Among men previous cardiovascular disease, diabetes and low socio-economic position increased the risk. During the observation period, there was no change in sickness absence rates among PCI patients but an increase among CABG patients adjusting for patient characteristics.ConclusionThis national study covering a 13-year period shows that long-term sickness absence following coronary revascularisation is common in Sweden, especially among women, and is associated with socio-economic position, co-morbidity, and sickness absence during the year before the intervention. Gender specific scientific knowledge about use and effects of sickness absence following coronary revascularisation is warranted for the patients, the treating physicians, the healthcare sector, and the society.

Predictors of permanent work disability among ≤50-year-old patients undergoing percutaneous coronary intervention

“…Early and active collaboration with occupational healthcare physicians and rehabilitation could be potential targets for improving later working capacity in young patients. Gender did not independently influence the risk of disability unlike the earlier literature on disability in general and after PCI (35)(36)(37). Remarkably even the higher baseline disease burden among women in the present study (data not shown) did not alter the incidence of PWD.…”

Impact of Gender, Co-Morbidity and Social Factors on Labour Market Affiliation after First Admission for Acute Coronary Syndrome. A Cohort Study of Danish Patients 2001–2009

“…Similar associations have been found for patients who have had a CABG [3]–[7] or PCI [7]. These studies have in most cases included small, selected patient groups and incomplete follow-up, particularly because outcome data in many studies were collected by questionnaire.…”

“…Low SEP has predicted lower rates of return to work in most other studies [3]–[5], [7]. This might reflect that high SEP jobs are more flexible with regard to taking changes in work capacity into account and that work ability in low SEP jobs is more affected by ACS than in high SEP jobs.…”

“…This study showed that sick leave following coronary revascularisation was common, especially among women, and was also associated with SEP and co-morbidity [7]. In another population-based study from Finland, return to work was examined by the linkage of the Finnish cardiovascular register with a register for social security benefits for 5,074 patients aged 35–59 who had survived their first myocardial infarction (MI) between 1991 and 1996.…”

Effectiveness of person-centred care after acute coronary syndrome in relation to educational level: Subgroup analysis of a two-armed randomised controlled trial

“…Moreover, such patients are less responsive to accomplish healthy lifestyle changes post-MI than those with a higher socioeconomic status [3]. Return to work is complicated and prolonged sick leave is common in cardiac populations [4,5]. Cardiac rehabilitation is a multifaceted intervention that includes psychosocial and educational counselling as well as exercise training, which are associated with a reduction in the risk of recurrent MI and mortality, as well as sustained improvements in health-related quality of life [6].…”