Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark.
Department of Cardiology, Aalborg University Hospital, Denmark.
J Stroke Cerebrovasc Dis. 2021 Nov;30(11):106031. doi: 10.1016/j.jstrokecerebrovasdis.2021.106031. Epub 2021 Aug 24.
The ability to remain in employment addresses an important consequence of stroke beyond the usual clinical parameters. However, data on the association between time to intravenous thrombolysis and workforce attachment in patients with acute ischemic stroke are sparse.
In this nationwide cohort study, stroke patients of working age (18-60 years) treated with thrombolysis (2011-2016) who were part of the workforce prior to admission and alive at discharge were identified using the Danish Stroke Registry. The association between time to thrombolysis and workforce attachment one year later was examined with multivariable logistic regression.
The study population comprised 1,329 patients (median age 51 years [25-75 percentile 45-56], 67.3% men). The median National Institutes of Health Stroke Scale score at presentation was 4 (25-75 percentile 2-8), and the median time from symptom-onset to initiation of thrombolysis was 140min (25-75 percentile 104-196min). The proportion of patients who were part of the workforce at one-year follow-up was 64.6%, 64.3%, 64.9%, and 60.0% in patients receiving thrombolysis within 90min, between 91-180min, between 181-270min, and after 270min, respectively. In adjusted analysis, time to thrombolysis between 91-180min, 181-270min, and >270min was not significantly associated with workforce attachment compared with thrombolysis received ≤90min of symptom-onset (ORs 0.89 [95%CI 0.60-1.31], 0.93 [0.66-1.31], and 0.80 [0.43-1.52], respectively).
In patients of working age admitted with stroke and treated with thrombolysis, two out of three were part of the workforce one year after discharge. There was no graded relationship between time to thrombolysis and the likelihood of workforce attachment.
除了通常的临床参数之外，能够继续就业反映了卒中的一个重要后果。然而，关于急性缺血性卒中患者静脉溶栓治疗时间与劳动力关系的数据很少。
在这项全国性队列研究中，通过丹麦卒中登记处确定了在入院前处于工作状态且出院时存活的年龄在 18-60 岁之间（工作年龄）接受溶栓治疗（2011-2016 年）的卒中患者。使用多变量逻辑回归检查溶栓治疗与一年后劳动力关系的时间关系。
研究人群包括 1329 名患者（中位年龄 51 岁[25-75 百分位数 45-56]，67.3%为男性）。就诊时的中位 NIH 卒中量表评分为 4 分（25-75 百分位数 2-8 分），症状发作至溶栓开始的中位时间为 140 分钟（25-75 百分位数 104-196 分钟）。在一年的随访中，分别有 64.6%、64.3%、64.9%和 60.0%的患者在 90 分钟内接受溶栓治疗、91-180 分钟、181-270 分钟和>270 分钟内接受溶栓治疗，属于劳动力人群。在调整分析中，与症状发作≤90 分钟接受溶栓治疗相比，91-180 分钟、181-270 分钟和>270 分钟的溶栓治疗时间与劳动力关系无显著相关性（OR 0.89[95%CI 0.60-1.31]、0.93[0.66-1.31]和 0.80[0.43-1.52]）。
在因卒中住院且接受溶栓治疗的工作年龄患者中，有三分之二的患者在出院后一年仍属于劳动力人群。溶栓治疗时间与劳动力关系无明显的分级关系。
