Thurin Erik, Corell Alba, Gulati Sasha, Smits Anja, Henriksson Roger, Bartek J, Salvesen Øyvind, Jakola Asgeir Store
Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Sweden.
Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Neurooncol Pract. 2020 Jun;7(3):320-328. doi: 10.1093/nop/npz066. Epub 2019 Dec 16.
Meningioma is the most common primary intracranial tumor. It is usually slow growing and benign, and surgery is the main treatment modality. There are limited data on return to work following meningioma surgery. The objective of this study was to determine the patterns of sick-leave rate prior to surgery, and up to 2 years after, in patients compared to matched controls.
Data on patients ages 18 to 60 years with histologically verified intracranial meningioma between 2009 and 2015 were identified in the Swedish Brain Tumor Registry (SBTR) and linked to 3 national registries after 5 matched controls were assigned to each patient.
We analyzed 956 patients and 4765 controls. One year prior to surgery, 79% of meningioma patients and 86% of controls were working ( < .001). The proportion of patients at work 2 years after surgery was 57%, in contrast to 84% of controls ( < .001). Statistically significant negative predictors for return to work in patients 2 years after surgery were high (vs low) tumor grade, previous history of depression, amount of sick leave in the year preceding surgery, and surgically acquired neurological deficits.
There is a considerable risk for long term sick leave 2 years after meningioma surgery. Neurological impairment following surgery was a modifiable risk factor increasing the risk for long-term sick leave. More effective treatment of depression may facilitate return to work in this patient group.
脑膜瘤是最常见的原发性颅内肿瘤。它通常生长缓慢且为良性,手术是主要的治疗方式。关于脑膜瘤手术后重返工作岗位的数据有限。本研究的目的是确定与匹配对照组相比,患者术前及术后长达2年的病假率模式。
在瑞典脑肿瘤登记处(SBTR)中识别出2009年至2015年间年龄在18至60岁、经组织学证实为颅内脑膜瘤的患者数据,并在为每位患者分配5名匹配对照后与3个国家登记处进行关联。
我们分析了956例患者和4765例对照。术前一年,79%的脑膜瘤患者和86%的对照在工作(P<0.001)。术后2年仍在工作的患者比例为57%,而对照组为84%(P<0.001)。术后2年患者重返工作岗位的统计学显著负性预测因素为高(与低相比)肿瘤分级、既往抑郁症病史、术前一年的病假天数以及手术获得性神经功能缺损。
脑膜瘤手术后2年有相当大的长期病假风险。手术后的神经功能损害是一个可改变的风险因素,增加了长期病假的风险。更有效的抑郁症治疗可能有助于该患者群体重返工作岗位。