Department of Neuroscience, Neurosurgery, Uppsala University, SE-751 85 Uppsala, Sweden
Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institute, SE-171 77 Stockholm, Sweden.
BMJ Open. 2021 Jan 25;11(1):e040941. doi: 10.1136/bmjopen-2020-040941.
The aim was to describe the course of sickness absence (SA), disability pension (DP) and work-related economic situation defined as earnings (EA) and disposable income (DI), after spontaneous subarachnoid haemorrhage (SAH). Associations of SA, DP, EA and DI with demographic factors were also studied.
A longitudinal cohort study of all 1932 people in Sweden who in January 2005 to December 2010 had a first time SAH when aged 17 to 64 years and survived during the 3-year follow-up. Microdata from four nationwide administrative registers were used.
Primary outcome was the presence of SA and DP and how this changed during the study period of 5 years (the year before, the year of SAH and the following 3 years). The secondary outcome was the development of the income variables EA and DI. Demographic factors analysed were sex, age, source of bleeding, country of birth, family situation, educational level and type of living area.
The year before the SAH, 7.9% of women and 4.6% of men had some SA registered (p<0.004). A model consisting of female sex, higher education and living single predicted having SA that year. At the end of the follow-up, 39.2% of women and 28.3% of men had SA and/or DP (p<0.0001). A model consisting of female sex, living in a village/ rural area and having a defined bleeding source for the SAH was predicting having SA and/or DP at end of follow-up. The levels of EA decreased, while DI increased during follow-up and were at the end of follow-up associated with age, sex, type of living area, country of birth, educational level and family situation. The women's EA was lower than the men's during all years.
SAH influenced future SA, DP, as well as EA. Both SA, DP and the economic variables studied were predicted by models including sex.
描述自发性蛛网膜下腔出血（SAH）后，病假（SA）、残疾抚恤金（DP）和与工作相关的经济状况（定义为收入（EA）和可支配收入（DI））的发展过程。还研究了 SA、DP、EA 和 DI 与人口统计学因素的关联。
这是一项对瑞典所有 1932 名年龄在 17 至 64 岁之间的人进行的纵向队列研究，这些人在 2005 年 1 月至 2010 年 12 月期间首次发生 SAH，并在 3 年的随访期间存活。使用了四个全国性行政登记册的微观数据。
主要结果是存在 SA 和 DP，以及在 5 年的研究期间（SAH 前一年、SAH 当年和随后的 3 年）这一情况如何变化。次要结果是收入变量 EA 和 DI 的发展。分析的人口统计学因素包括性别、年龄、出血源、出生地、家庭状况、教育水平和居住区域类型。
在 SAH 前一年，7.9%的女性和 4.6%的男性有 SA 记录（p<0.004）。一个由女性性别、高等教育和单身居住组成的模型预测当年会出现 SA。在随访结束时，39.2%的女性和 28.3%的男性有 SA 和/或 DP（p<0.0001）。一个由女性性别、居住在村庄/农村地区和 SA 的明确出血源组成的模型预测在随访结束时会出现 SA 和/或 DP。在随访期间，EA 水平下降，而 DI 增加，在随访结束时与年龄、性别、居住区域类型、出生地、教育水平和家庭状况相关。在所有年份，女性的 EA 都低于男性。
SAH 影响未来的 SA、DP 以及 EA。SA、DP 和研究的经济变量都可以通过包括性别在内的模型来预测。
