Takahashi Paul Y, Ryu Euijung, Jenkins Gregory D, Yost Kathleen J, Kirt Christine R, Larson Nicole L, Gupta Ruchi, Cerhan James R, Olson Janet E
Division of Community Internal Medicine, Mayo Clinic, Rochester, MN.
Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN.
Mayo Clin Proc Innov Qual Outcomes. 2022 Oct 20;6(6):552-563. doi: 10.1016/j.mayocpiqo.2022.09.003. eCollection 2022 Dec.
To determine the relationship between characteristics of employment and future hospitalization in older adults.
We conducted a survey of adults aged 65 years or older participating in the Mayo Clinic Biobank. Using a frequency-matched, case-control design, we compared patients who were hospitalized within 5 years of biobank enrollment (cases) with those who were not hospitalized (controls). We assessed the duration of work, age at first job, number of jobs, disability, retirement, and reasons for leaving work. We performed logistic regression analysis to assess the association of these factors with hospitalization, accounting for age, sex, comorbid conditions, and education level.
Among 3536 participants (1600 cases and 1936 controls; median age, 68.5 years; interquartile range, 63.4-73.9 years), cases were older, more likely to be male, and had lower education levels. Comorbid illnesses had the largest association with hospitalization (odds ratio [OR], 4.09; 95% CI, 3.37-4.97 [highest vs lowest quartile]). On adjusted analyses, odds of hospitalization increased with the presence of disability (OR, 1.31; 95% CI, 1.01-1.69) and decreased with having 1 or 2 lifetime jobs vs no employment (OR, 0.77; 95% CI, 0.60-1.00). The length of work, furlough, age of retirement, childcare issues, and reasons for leaving a job were not associated with hospitalization.
This study reports an association between disability during work and hospitalization. On the basis of our findings, it may be important to obtain a more detailed work history from patients because it may provide further insight into their future health.
确定老年人就业特征与未来住院治疗之间的关系。
我们对参与梅奥诊所生物样本库的65岁及以上成年人进行了一项调查。采用频率匹配的病例对照设计，我们将生物样本库入组后5年内住院的患者（病例）与未住院的患者（对照）进行了比较。我们评估了工作时长、首次工作年龄、工作数量、残疾情况、退休情况以及离职原因。我们进行了逻辑回归分析，以评估这些因素与住院治疗的关联，并考虑了年龄、性别、合并症和教育水平。
在3536名参与者中（1600例病例和1936名对照；中位年龄68.5岁；四分位间距63.4 - 73.9岁），病例年龄更大，男性比例更高，教育水平更低。合并症与住院治疗的关联最大（优势比[OR]，4.09；95%置信区间，3.37 - 4.97[最高四分位数与最低四分位数相比]）。在调整分析中，住院几率随着残疾的存在而增加（OR，1.31；95%置信区间，1.01 - 1.69），而与有1或2份终身工作相比无工作的情况相比则降低（OR，0.77；95%置信区间，0.60 - 1.00）。工作时长、休假、退休年龄、育儿问题以及离职原因与住院治疗无关。
本研究报告了工作期间的残疾与住院治疗之间的关联。基于我们的研究结果，从患者那里获取更详细的工作史可能很重要，因为这可能为他们未来的健康提供进一步的见解。
