Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
Disabil Rehabil. 2013 Apr;35(8):656-61. doi: 10.3109/09638288.2012.703756. Epub 2012 Aug 13.
Occupational consequences of musculoskeletal disorders (MSDs) are consistently found in epidemiological studies. The aim of this study was to evaluate the prognostic value of various short-term rehabilitation outcome parameters on early retirement in Germany.
In a prospective multi-centre cohort study of self-rated patient status, physician chosen therapy goals and attainment were measured by means of standardized questionnaires at the beginning and end of medical rehabilitation. Information with regard to disability was collected by self-report over a 5-year follow-up period.
We included 1268 MSD patients aged 45-57 who underwent a 3-week, multidisciplinary, in-patient rehabilitation programme in 10 rehabilitation centres in Southern Germany between January and December 2001. During follow-up (mean duration: 3.9 years) 117 (9%) patients received a disability pension. After adjustment for sex, age and patient outcomes, risk for early retirement was significantly increased for patients with only partial success with respect for the therapy goals pain reduction (HR 1.95), improvement in spine motility (HR 1.6) and improvement of muscle strength (HR 2.3). Patients who did not have the therapy goal were at the same risk as patients with full goal achievement.
Clinicians' rating of short-term therapy outcome might be of prognostic relevance of MSD patients' long-term employment status.
肌肉骨骼疾病（MSD）的职业后果在流行病学研究中经常被发现。本研究旨在评估各种短期康复结果参数对德国早期退休的预后价值。
在一项前瞻性多中心队列研究中，通过标准化问卷在医学康复开始和结束时评估自我评估的患者状况、医生选择的治疗目标和实现情况。在 5 年的随访期间，通过自我报告收集残疾信息。
我们纳入了 2001 年 1 月至 12 月期间在德国南部 10 个康复中心接受为期 3 周的多学科住院康复计划的 1268 名 45-57 岁 MSD 患者。在随访期间（平均持续时间：3.9 年），有 117 名（9%）患者领取了残疾抚恤金。在调整了性别、年龄和患者结局后，仅在治疗目标疼痛减轻（HR 1.95）、脊柱运动能力改善（HR 1.6）和肌肉力量改善（HR 2.3）方面部分成功的患者，其提前退休的风险显著增加。没有治疗目标的患者与完全实现治疗目标的患者风险相同。
临床医生对短期治疗结果的评估可能与 MSD 患者长期就业状况的预后相关。
