Endo Motoki, Sairenchi Toshimi, Kojimahara Noriko, Haruyama Yasuo, Sato Yasuto, Kato Rika, Yamaguchi Naohito
Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan.
Department of Public Health, Dokkyo Medical University, Mibu Town, Japan.
BMJ Open. 2016 Jan 4;6(1):e009682. doi: 10.1136/bmjopen-2015-009682.
The objective of this study was to investigate the cumulative return to work (RTW) rate and to clarify the predictors of the time to full-time RTW (full RTW) and resignation among Japanese stroke survivors, within the 365-day period following their initial day of sickness absence due to stroke.
This study was based on tertiary prevention of occupational health in large-scaled Japanese companies of various industries.
The participants in this study were 382 Japanese workers who experienced an episode of sickness leave due to clinically certified stroke diagnosed between 1 January 2000 and 31 December 2011. Data were obtained from an occupational health register. Participants were followed up for 365 days after the start day of the first sickness absence. The cumulative RTW rates by Kaplan-Meier estimates and predictors for time to full RTW and resignation by Cox regression were calculated.
A total of 382 employees had their first sickness absence due to stroke during the 12-year follow-up period. The cumulative full RTW rates at 60, 120, 180 and 365 days were 15.1%, 33.6%, 43.5% and 62.4%, respectively. Employees who took sick leave due to cerebral haemorrhage had a longer time to full RTW (HR, 0.50; 95% CI 0.36 to 0.69) than those with cerebral infarction. Older employees (over 50 years of age) demonstrated a shorter time to resignation than younger employees (HR, 3.30; 95% CI 1.17 to 9.33). Manual workers had a longer time to resignation than non-manual workers (HR, 0.24; 95% CI 0.07 to 0.78).
Cumulative RTW rates depended on the subtype of stroke, and older age was a predictor of resignation.
本研究的目的是调查日本中风幸存者在因中风首次缺勤之日起365天内的累积重返工作岗位（RTW）率，并阐明全职RTW（完全RTW）时间和辞职的预测因素。
本研究基于日本各行业大型公司职业健康的三级预防。
本研究的参与者为382名日本工人，他们在2000年1月1日至2011年12月31日期间因临床确诊中风而经历过病假。数据来自职业健康登记册。参与者在首次缺勤开始之日后随访365天。通过Kaplan-Meier估计计算累积RTW率，并通过Cox回归计算完全RTW时间和辞职的预测因素。
在12年的随访期内，共有382名员工因中风首次缺勤。60天、120天、180天和365天的累积完全RTW率分别为15.1%、33.6%、43.5%和62.4%。因脑出血休病假的员工完全RTW的时间比脑梗死员工更长（风险比[HR]，0.50；95%置信区间[CI]为0.36至0.69）。年龄较大的员工（50岁以上）辞职时间比年轻员工短（HR，3.30；95%CI为1.17至9.33）。体力劳动者辞职时间比非体力劳动者长（HR，0.24；95%CI为0.07至0.78）。
累积RTW率取决于中风的亚型，年龄较大是辞职的一个预测因素。
