Department of Anaesthesiology and Intensive Care Medicine, Aalborg University Hospital, Hobrovej 18-22, 9100, Aalborg, Denmark.
Clinical Institute, Aalborg University, Aalborg, Denmark.
Intensive Care Med. 2018 Apr;44(4):418-427. doi: 10.1007/s00134-018-5157-1. Epub 2018 Apr 3.
The association between severity of illness and ability to return to work is unclear. Therefore, we investigated return to work and associations with measures of illness severity in ICU survivors.
We conducted this cohort study using Danish registry data for the period 2005-2014 on ICU patients who were discharged alive from hospital, had an ICU length of stay (LOS) of at least 72 h, were not treated with dialysis before hospital admission and were working prior to admission. We assessed (1) the cumulative incidence (chance) of return to work (2005-2017) and receipt of social benefits after discharge from a hospital stay with ICU admission and (2) the association between organ support therapies (renal replacement therapy, cardiovascular support and mechanical ventilation), and during 2011-2014 SAPS II and ICU LOS, and return to work, using multivariable Cox regression.
Among 5762 ICU survivors, 68% returned to work within 2 years after hospital discharge. Disability and sickness benefits constituted 89% of social benefits among patients not returning to work and 59% among patients withdrawing from work following an initial return to work. Mechanical ventilation (HR 0.70, 95% CI [0.65-0.77]), but not RRT (HR 0.85, 95% CI [0.71-1.02]), cardiovascular support (HR 0.93, 95% CI [0.82-1.07]) and increasing SAPS II, was associated with decreased chance of return to work. Increasing ICU LOS was also associated with a decreased chance of return to work.
The majority of a nationwide cohort of ICU survivors returned to work. Sick leave and receipt of disability pension were common following ICU admission. Mechanical ventilation and longer ICU LOS were associated with reduced chances of return to work.
疾病严重程度与恢复工作能力之间的关系尚不清楚。因此，我们调查了 ICU 幸存者的工作恢复情况以及与疾病严重程度指标的关系。
我们使用丹麦登记数据进行了这项队列研究，研究对象为 2005 年至 2014 年期间从医院出院且存活、入住 ICU 的 ICU 住院时间（LOS）至少为 72 小时、住院前未接受透析且在入院前工作的 ICU 患者。我们评估了（1）从 ICU 住院到出院后（2005-2017 年）返回工作的累积发生率（机会）和接受社会福利的情况，（2）器官支持治疗（肾脏替代治疗、心血管支持和机械通气）与 2011 年至 2014 年 SAPS II 和 ICU LOS 之间的关系，以及返回工作的情况，使用多变量 Cox 回归。
在 5762 名 ICU 幸存者中，有 68%的人在出院后 2 年内返回工作。未返回工作的患者中，残疾和病假福利占社会福利的 89%，而最初返回工作后退出工作的患者中，这一比例为 59%。机械通气（HR 0.70，95%CI [0.65-0.77]），但不是肾脏替代治疗（HR 0.85，95%CI [0.71-1.02]）、心血管支持（HR 0.93，95%CI [0.82-1.07]）和增加 SAPS II，与返回工作的机会降低有关。ICU LOS 的增加也与返回工作的机会降低有关。
全国性 ICU 幸存者队列的大多数人都返回了工作岗位。入住 ICU 后请病假和领取残疾抚恤金很常见。机械通气和较长的 ICU LOS 与重返工作的机会减少有关。
