Horsboel Trine A, Nielsen Claus V, Andersen Niels T, Nielsen Bendt, de Thurah Annette
Department of Haematology, Aarhus University Hospital , Denmark.
Acta Oncol. 2014 Jun;53(6):724-34. doi: 10.3109/0284186X.2013.875625. Epub 2014 Jan 23.
Patients with haematological malignancies are at increased risk of experiencing work-related problems. The aims of this study were to compare the risk of disability pension (DP) among patients diagnosed with eight subtypes of haematological malignancies to a reference cohort, and to determine if relative risks differ between these subtypes; to evaluate the influence of socioeconomic factors, demographic factors, and clinical factors on the risk of DP; and to investigate if these associations differ between the reference cohort and the patient cohort.
We combined data from national registers on Danish patients diagnosed with haematological malignancies between 2000 and 2007 and a reference cohort without a history of these diseases. A total of 3194 patients and 28 627 reference individuals were followed until DP, emigration, old age pension or anticipatory pension, death or 26 February 2012, whichever came first.
A total of 550 (17%) patients and 1511 (5%) reference individuals were granted DP. Age- and gender-adjusted relative risks differed significantly between the subgroups of haematological malignancies and ranged from 2.64 (95% CI 1.84-3.78) for patients with Hodgkin lymphoma to 12.53 (95% CI 10.57-14.85) for patients with multiple myeloma. In the patient cohort we found that gender, age, comorbidity, ethnicity, educational level, household income, history of long-term sick leave, and need of treatment with anxiolytics or antidepressants after diagnosis were associated with receiving DP. However, most of these associations were stronger in the reference cohort.
All eight subtypes of haematological malignancies were associated with an increased risk of DP compared to the reference cohort. The relative risks differed according to subtype, and patients with multiple myeloma had the highest risk of DP. Furthermore, most socioeconomic, demographic and clinical factors had a stronger impact on the risk of DP in the reference cohort than in the patient cohort.
血液系统恶性肿瘤患者出现与工作相关问题的风险增加。本研究的目的是比较被诊断为八种血液系统恶性肿瘤亚型的患者与参照队列中领取残疾抚恤金(DP)的风险,并确定这些亚型之间的相对风险是否存在差异;评估社会经济因素、人口统计学因素和临床因素对领取DP风险的影响;以及调查这些关联在参照队列和患者队列之间是否存在差异。
我们将丹麦国家登记处中2000年至2007年间被诊断为血液系统恶性肿瘤的患者数据与无这些疾病病史的参照队列数据相结合。总共3194名患者和28627名参照个体被随访至领取DP、移民、领取老年抚恤金或提前退休金、死亡或2012年2月26日,以先发生者为准。
共有550名(17%)患者和1511名(5%)参照个体获得了DP。血液系统恶性肿瘤亚组之间经年龄和性别调整的相对风险存在显著差异,范围从霍奇金淋巴瘤患者的2.64(95%置信区间1.84 - 3.78)到多发性骨髓瘤患者的12.53(95%置信区间10.57 - 14.85)。在患者队列中,我们发现性别、年龄、合并症、种族、教育水平、家庭收入、长期病假史以及诊断后使用抗焦虑药或抗抑郁药的需求与领取DP有关。然而,这些关联中的大多数在参照队列中更强。
与参照队列相比,所有八种血液系统恶性肿瘤亚型均与领取DP的风险增加相关。相对风险因亚型而异,多发性骨髓瘤患者领取DP的风险最高。此外,大多数社会经济、人口统计学和临床因素对参照队列中领取DP风险的影响比对患者队列更强。