Calvo-Bonacho Eva, Catalina-Romero Carlos, Cabrera Martha, Fernández-Labandera Carlos, Sánchez Chaparro Miguel Ángel, Brotons Carlos, Ruilope Luis Miguel
Departamento de Proyectos Sanitarios, Ibermutuamur (Mutua colaboradora con la Seguridad Social 274), Madrid, Spain.
Departamento de Proyectos Sanitarios, Ibermutuamur (Mutua colaboradora con la Seguridad Social 274), Madrid, Spain.
Rev Esp Cardiol (Engl Ed). 2017 Nov;70(11):941-951. doi: 10.1016/j.rec.2017.02.017. Epub 2017 Mar 11.
The purpose of this study was to investigate whether changes in cardiovascular risk (CVR) are associated with the length and cost of sickness absence.
A prospective cohort of 179 186 participants was evaluated. Each participant's CVR (SCORE) was assessed on 2 consecutive medical examinations, approximately 1 year apart (365 ± 90 days). Cardiovascular risk was categorized as < 4% or ≥ 4%, and participants were divided into 4 groups according to changes in their risk between the 2 assessments. After the second CVR estimate, a 1-year follow-up was carried out to assess sickness absence. Differences between the 4 groups in terms of the total count of sickness absence days during the follow-up period were tested using Poisson regression models.
After adjustment for covariates, participants who showed an improvement in CVR had a lower count of sickness absence days compared with both those who showed a worsening in risk and those who remained stable at ≥ 4% (RR, 0.91; 95%CI, 0.84-0.98). In comparison with participants whose CVR did not improve, more of the participants whose risk did improve had quit smoking (+17.2%; P < .001), and had controlled their blood pressure (+26.0%, P < .001), total cholesterol (+9.3%; P < .001), low-density lipoprotein cholesterol (+14.9%; P < .001), and triglyceride levels (+14.6%; P < .001).
Our results suggest that an improvement in CVR profile is accompanied by a decrease in sickness absence during a 1-year follow-up.
本研究旨在调查心血管风险（CVR）的变化是否与病假时长及费用相关。
对179186名参与者的前瞻性队列进行评估。每位参与者的CVR（SCORE）在两次连续的医学检查中进行评估，两次检查间隔约1年（365±90天）。心血管风险被分类为<4%或≥4%，参与者根据两次评估之间风险的变化分为4组。在第二次CVR评估后，进行为期1年的随访以评估病假情况。使用泊松回归模型测试4组在随访期间病假天数总数方面的差异。
在对协变量进行调整后，与风险恶化的参与者以及风险保持在≥4%稳定状态的参与者相比，CVR有所改善的参与者病假天数更少（RR，0.91；95%CI，0.84 - 0.98）。与CVR未改善的参与者相比，风险确实有所改善的参与者中，更多人戒烟（+17.2%；P<.001），并控制了血压（+26.0%，P<.001）、总胆固醇（+9.3%；P<.001）、低密度脂蛋白胆固醇（+14.9%；P<.001）和甘油三酯水平（+14.6%；P<.001）。
我们的结果表明，在1年的随访期间，CVR状况的改善伴随着病假天数的减少。
