Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria.
Eur J Public Health. 2019 Jun 1;29(3):531-540. doi: 10.1093/eurpub/cky279.
Scientific knowledge on risk factors for work disability in terms of long-term sickness absence (SA) and disability pension (DP) following acute myocardial infarction (AMI) is limited. The study aimed to investigate socio-demographic, work-related and medical characteristics as risk factors for long-term SA (>90 days) and DP in patients with a first AMI.
This is a population-based cohort study of 8199 individuals aged 19-60 years who had a first AMI during 2008-10 and were alive 30 days after AMI. Univariate and multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) with regard to long-term SA and DP with a 3-year follow-up were estimated by Cox regression.
We found a higher risk of long-term SA and DP after AMI in women, those with lower education and previous SA (range of HRs: 1.29-7.34). Older age and being born in non-European countries were associated with a 2- to 3-fold higher risk of DP. Moreover, ST-elevation myocardial infarction (STEMI), musculoskeletal and common mental disorders (CMDs) were risk factors for long-term SA and DP, while diabetes mellitus and stroke were associated with a higher risk of DP (range of HRs: 1.12-2.98). Coronary artery bypass grafting (CABG) compared with percutaneous coronary intervention was associated with a 2-fold higher risk of work disability.
Older women, those with lower education and non-European immigrants had a higher risk of work disability after AMI, particularly permanent work disability. STEMI, CABG, diabetes mellitus, stroke, musculoskeletal disorders and CMDs provide important clinical information for work disability after AMI.
关于急性心肌梗死（AMI）后长期病假（SA）和残疾抚恤金（DP）的风险因素，科学知识有限。本研究旨在调查社会人口统计学、工作相关和医疗特征作为首次 AMI 患者长期 SA（>90 天）和 DP 的风险因素。
这是一项基于人群的队列研究，共纳入 8199 名年龄在 19-60 岁之间的个体，他们在 2008-2010 年期间首次发生 AMI，并且在 AMI 后 30 天存活。通过 Cox 回归估计了与 3 年随访相关的长期 SA 和 DP 的单变量和多变量风险比（HR）和 95%置信区间（CI）。
我们发现，女性、受教育程度较低和有既往 SA 的个体在发生 AMI 后，长期 SA 和 DP 的风险更高（HR 范围：1.29-7.34）。年龄较大和出生在非欧洲国家与 DP 的风险增加 2-3 倍相关。此外，ST 段抬高型心肌梗死（STEMI）、肌肉骨骼和常见精神障碍（CMD）是长期 SA 和 DP 的风险因素，而糖尿病和中风与 DP 的风险增加相关（HR 范围：1.12-2.98）。与经皮冠状动脉介入治疗相比，冠状动脉旁路移植术（CABG）与工作残疾的风险增加 2 倍相关。
年龄较大的女性、受教育程度较低的个体和非欧洲移民在发生 AMI 后工作残疾的风险较高，尤其是永久性工作残疾。STEMI、CABG、糖尿病、中风、肌肉骨骼疾病和 CMD 为 AMI 后工作残疾提供了重要的临床信息。
