Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), C/ Ramirez de Arellano, 27, 28043 Madrid, Spain.
Eur Heart J. 2014 Feb;35(5):299-306. doi: 10.1093/eurheartj/eht156. Epub 2013 May 2.
We investigated the potential influence of a moderate-to-high cardiovascular (CV) risk (CVR) (defined as a Systematic COronary Risk Evaluation model, or SCORE ≥ 4%), in the absence of an established CV disease, on the duration and cost of CV and non-CV sick leave (SL) resulting from common and occupational accidents or diseases.
We conducted a prospective cohort study on 690 135 workers with a 1-year follow-up and examined CV- and non-CV-related SL episodes. To obtain baseline values, CVR factors were initially assessed at the beginning of the year during routine medical examination. The CVR was calculated with the SCORE charts for all subjects. Moderate-to-high CVR was defined as SCORE ≥ 4%. A baseline SCORE ≥ 4% was associated with a higher risk for long-term CV and non-CV SL, as revealed by follow-up assessment. This translated into an increased cost, estimated at €5 801 464.18 per year. Furthermore, pharmacological treatment for hypertension or hyperlipidaemia was significantly associated with longer SL duration.
Moderate-to-high CVR in asymptomatic subjects was significantly associated with the duration and cost of CV and non-CV SL. These results constitute the first body of evidence that the SCORE charts can be used to identify people with a non-established CV disease, which might ultimately translate into more lost workdays and therefore increased cost for society.
我们研究了在不存在既定心血管疾病的情况下，中高度心血管（CV）风险（CVR）（定义为系统性冠状动脉风险评估模型或 SCORE≥4%）对常见和职业性事故或疾病导致的 CV 和非 CV 病假（SL）持续时间和成本的潜在影响。
我们对 690135 名工人进行了一项为期 1 年的前瞻性队列研究，并检查了 CV 和非 CV 相关的 SL 发作。为了获得基线值，首先在年初进行常规体检时评估 CVR 因素。所有受试者均使用 SCORE 图表计算 CVR。中高度 CVR 定义为 SCORE≥4%。基线 SCORE≥4%与长期 CV 和非 CV SL 的高风险相关，这是通过随访评估得出的。这转化为成本的增加，估计每年为 5801464.18 欧元。此外，高血压或高脂血症的药物治疗与 SL 持续时间延长显著相关。
无症状受试者的中高度 CVR 与 CV 和非 CV SL 的持续时间和成本显著相关。这些结果首次证明 SCORE 图表可用于识别尚未患有 CV 疾病的人群，这可能最终导致更多的工作日损失，从而增加社会成本。
