Jansson Catarina, Wiberg Michael, Alexanderson Kristina
Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Scand J Gastroenterol. 2013 Jan;48(1):17-26. doi: 10.3109/00365521.2012.737359. Epub 2012 Nov 27.
Gastroesophageal reflux disease (GERD) is a major public health problem in the Western world. No previous population-based nationwide study has, however, examined the occurrence of sickness absence due to GERD diagnoses, that is, the aim of this study.
Nationwide population-based study based on Swedish registers including all 4,764,843 individuals registered as living in Sweden in 31 December 2004 and 31 December 2005, aged 20-64 years, not on disability or old age pension. Reimbursed sickness absence due to reflux diagnoses (ICD-10), that is, GERD (K21), esophagitis (K20), and heartburn (R12), was studied separately and combined. In analyses stratified by sociodemographic factors, inpatient/specialized outpatient care, antireflux surgery, and prescribed reflux medications those sickness absent in 2005 due to reflux diagnoses were compared to those sickness absent due to non-reflux diagnoses and to those with no sickness benefits 2005.
In total, 627 individuals had at least one prevalent sick-leave spell due to reflux diagnoses in 2005, of which GERD was the most common diagnosis. Of these, almost half (45%) was absent for ≥ 28 reimbursed sick-leave days due to reflux diagnoses. The proportions of low socioeconomic status (SES), inpatient and outpatient care due to tumors, mental disorders, circulatory disorders, GERD, antireflux surgery, and reflux medications were higher among those sickness absent due to reflux diagnoses compared to those with no sickness benefits.
In this nationwide population-based study a high proportion of those sickness absent due to reflux diagnoses was on long-term sick leave, a finding that warrants attention.
胃食管反流病（GERD）是西方世界的一个主要公共卫生问题。然而，此前尚无基于全国人口的研究调查过因GERD诊断而导致的病假情况，而这正是本研究的目的。
基于瑞典登记系统的全国人口研究，纳入了2004年12月31日和2005年12月31日在瑞典登记居住的所有4,764,843名20至64岁、未领取残疾或养老金的个体。分别研究并综合分析了因反流诊断（国际疾病分类第10版，即GERD（K21）、食管炎（K20）和烧心（R12））而获得补偿的病假情况。在按社会人口学因素、住院/专科门诊护理、抗反流手术和开具的反流药物分层的分析中，将2005年因反流诊断而病假的人与因非反流诊断而病假的人以及2005年未领取病假福利的人进行了比较。
2005年共有627人因反流诊断至少有一次病假记录，其中GERD是最常见的诊断。其中，近一半（45%）因反流诊断而有≥28天的补偿病假。与未领取病假福利的人相比，因反流诊断而病假的人中社会经济地位低、因肿瘤、精神障碍、循环系统疾病、GERD、抗反流手术和反流药物而接受住院和门诊护理的比例更高。
在这项基于全国人口的研究中，因反流诊断而病假的人中有很大比例处于长期病假状态，这一发现值得关注。
