Finnish Institute of Occupational Health, Helsinki, Finland
Department of Public Health, University of Helsinki, Finland.
J Am Heart Assoc. 2018 Jan 4;7(1):e006991. doi: 10.1161/JAHA.117.006991.
Although a stroke event often leads to work disability, diagnoses behind work disability before and after stroke are largely unknown. We examined the pre-event and postevent trends in diagnosis-specific work disability among patients of working age.
We included all new nonfatal stroke events in 2006-2008 from population-based hospital registers in Sweden among women and men aged 25 to 60 years (n=12 972). Annual days of diagnosis-specific work disability were followed for 4 years before and after stroke. Repeated measures negative binomial regression models using the generalized estimating equations method were fitted to examine trends in diagnosis-specific work disability before and after the event. Already during the 4 pre-event years, work disability attributed to circulatory diseases increased among women (rate ratio, 1.99; 95% confidence interval, 1.68-2.36) and men (rate ratio, 2.20; 95% confidence interval, 1.88-2.57). Increasing trends before stroke were also found for work disability attributed to mental disorders, musculoskeletal diseases, neoplasms, diseases of the nervous, respiratory, and digestive systems, injuries, and diabetes mellitus. As expected, a sharp increase in work disability days attributed to circulatory diseases was found during the first year after the event among both sexes. Overall, during 4 years after the stroke, there was a decreasing trend for circulatory diseases and injuries, whereas the trend was increasing for nervous diseases and diabetes mellitus.
Work disability attributed to several mental and somatic diagnoses is higher already before a stroke event.
尽管中风事件通常会导致工作能力丧失，但工作能力丧失之前和之后的诊断在很大程度上是未知的。我们研究了工作年龄患者中风前后特定诊断的工作能力丧失的前事件和后事件趋势。
我们纳入了瑞典基于人群的医院登记处 2006-2008 年期间所有新的 25-60 岁女性和男性非致命性中风事件（n=12972）。在中风前后的 4 年内，每年特定诊断的工作能力丧失天数都被随访。使用广义估计方程方法拟合重复测量负二项回归模型，以检查事件前后特定诊断的工作能力丧失趋势。在事件前的 4 年中，女性（率比，1.99；95%置信区间，1.68-2.36）和男性（率比，2.20；95%置信区间，1.88-2.57）归因于循环系统疾病的工作能力丧失已经增加。在中风前也发现了归因于精神障碍、肌肉骨骼疾病、肿瘤、神经系统、呼吸系统和消化系统疾病、损伤和糖尿病的工作能力丧失的上升趋势。正如预期的那样，在男女两性中，在事件发生后的第一年，归因于循环系统疾病的工作能力丧失天数急剧增加。总体而言，在中风后的 4 年内，循环系统疾病和损伤的趋势呈下降趋势，而神经系统疾病和糖尿病的趋势呈上升趋势。
在中风事件之前，已经有几个精神和躯体诊断的工作能力丧失较高。
