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[腹股沟疝的术前阶段及与工作无关的病假情况]

[Pre-surgical period and non-work-related sickness absence due to inguinal hernia].

作者信息

Ruiz-Moraga Montserrat, Catalina-Romero Carlos, Martínez-Muñoz Paloma, Cobo-Santiago María Dolores, González-López Maite, Cabrera-Sierra Martha, Porrero-Carro José Luis, Calvo-Bonacho Eva

机构信息

Ibermutuamur (Mutua de accidentes de trabajo y enfermedades profesionales de la Seguridad Social n.° 274), Madrid, España.

Ibermutuamur (Mutua de accidentes de trabajo y enfermedades profesionales de la Seguridad Social n.° 274), Madrid, España.

出版信息

Cir Esp. 2014 Apr;92(4):269-76. doi: 10.1016/j.ciresp.2012.11.016. Epub 2013 Apr 8.

Abstract

BACKGROUND AND OBJECTIVE

To analyze non-work-related sickness absence (NWR-SA) due to inguinal hernia and the factors related to its duration, paying particular attention to the pre-surgical period of NWR-SA.

MATERIAL AND METHODS

Prospective cohort study was conducted on 1,003 workers with an episode of NWR-SA due to an inguinal hernia, belonging to the insured population of a mutual insurance company. We assessed the duration of the NWR-SA episodes and the main demographic, occupational and clinical variables potentially related to it. Cox regression analyses were conducted to establish the predictors of NWR-SA duration.

RESULTS

The mean duration of NWR-SA due to inguinal hernia was 68.6 days. After multivariate analysis (Cox regression), having a pre-surgical period of NWR-SA (HR = 0.35; 95%CI: 0.28-0.43), manual occupations (HR=0.68; 95%CI: 0.49-0.95), construction sector (HR=0.71; 95%CI: 0.58-0.88), direct payment methods by a Mutual Insurance Company during sick leave in self-employed workers (HR=0.58; 95%CI, 0.41-0.82), or employees (HR=0.51; 95%CI: 0.36-0.72), comorbidity (HR=0.45; 95%CI:0.34-0.59), and surgery performed under an entity other than the Public Health System or a mutual insurance company (HR=0,76; 95%CI: 0.59-0.97) were associated with longer NWR-SA. The Mutual Insurance Company always performed the surgery when a pre-surgery period of NWR-SA existed (mean duration=47 ±39.6 days); that was associated with shorter periods of post-surgical NWR-SA (P=.001).

CONCLUSIONS

The NWR-SA due to inguinal hernia is a multifactorial phenomenon in which the pre-surgery period plays an important role. The collaboration between organizations involved in the management of NWR-SA seems to be an effective strategy for reducing its duration.

摘要

背景与目的

分析因腹股沟疝导致的非工伤病假(NWR-SA)及其持续时间的相关因素,尤其关注NWR-SA的术前阶段。

材料与方法

对1003名因腹股沟疝导致NWR-SA发作的工人进行前瞻性队列研究,这些工人属于一家互助保险公司的参保人群。我们评估了NWR-SA发作的持续时间以及可能与之相关的主要人口统计学、职业和临床变量。进行Cox回归分析以确定NWR-SA持续时间的预测因素。

结果

因腹股沟疝导致的NWR-SA平均持续时间为68.6天。多变量分析(Cox回归)后发现,存在NWR-SA术前阶段(HR = 0.35;95%CI:0.28 - 0.43)、体力劳动职业(HR = 0.68;95%CI:0.49 - 0.95)、建筑行业(HR = 0.71;95%CI:0.58 - 0.88)、自营职业者病假期间由互助保险公司直接支付费用(HR = 0.58;95%CI,0.41 - 0.82)或雇员(HR = 0.51;95%CI:0.36 - 0.72)、合并症(HR = 0.45;95%CI:0.34 - 0.59)以及在公共卫生系统或互助保险公司以外的实体进行手术(HR = 0.76;95%CI:0.59 - 0.97)与较长的NWR-SA相关。当存在NWR-SA术前阶段时,互助保险公司总是进行手术(平均持续时间 = 47 ± 39.6天);这与术后NWR-SA的较短持续时间相关(P = 0.001)。

结论

因腹股沟疝导致的NWR-SA是一种多因素现象,其中术前阶段起着重要作用。参与NWR-SA管理的组织之间的合作似乎是减少其持续时间的有效策略。

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