Mortensen Michael, Nilsen Roy M, Kvalheim Venny L, Bjørnstad Johannes L, Svendsen Øyvind S, Haaverstad Rune, Moi Asgjerd L
Department of Health and Caring Sciences, Western Norway University of Applied Sciences, P.O box 7030, 5020 Bergen, Norway.
Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway.
Eur Heart J Qual Care Clin Outcomes. 2024 Aug 8;10(5):431-445. doi: 10.1093/ehjqcco/qcad064.
To estimate sick leave (SL) duration after first-time elective open-heart surgery and identify factors contributing to increased SL.
A retrospective nationwide cohort study combined data from the Norwegian Register for Cardiac Surgery and SL data from the Norwegian Labour and Welfare Administrations. All able-bodied adults who underwent first-time elective open-heart surgery in Norway between 2012 and 2021 were followed until 1 year after surgery. The impact of socio-demographic and clinical factors on SL after surgery was analysed using logistic regression and odds ratios. Of 5456 patients, 1643 (30.1%), 1798 (33.0%), 971 (17.8%), 1035 (18.9%), and 9 (0.2%) had SL of <3, 3-6, 6-9, and 9-12 months, and 1 year, respectively. SL >6 months was associated with female gender, primary education only, and average annual income. Post-operative stroke, post-operative renal failure, New York Heart Association Functional Classification system (NYHA) score >3, earlier myocardial infarction, and diabetes mellitus increased the odds of SL >6 months.
This study demonstrates that socio-demographic and clinical factors impact SL after first-time elective open-heart surgery. Patients who experience a stroke or develop renal failure after surgery have the highest odds of SL >6 months. Females and patients with low education levels, earlier myocardial infarction, or NYHA scores III-IV have a two-fold chance of SL >6 months. The findings allow for future investigations of pre- and post-surgery interventions that can most effectively reduce SL and aid return to work.
评估首次择期心脏直视手术后的病假时长，并确定导致病假增加的因素。
一项全国性回顾性队列研究，将挪威心脏手术登记处的数据与挪威劳动和福利管理局的病假数据相结合。对2012年至2021年期间在挪威接受首次择期心脏直视手术的所有身体健全的成年人进行随访，直至术后1年。使用逻辑回归和比值比分析社会人口统计学和临床因素对术后病假的影响。在5456例患者中，分别有1643例（30.1%）、1798例（33.0%）、971例（17.8%）、1035例（18.9%）和9例（0.2%）的病假时长分别小于3个月、3至6个月、6至9个月、9至12个月和1年。病假时长超过6个月与女性、仅接受过小学教育以及平均年收入有关。术后中风、术后肾衰竭、纽约心脏协会功能分级系统（NYHA）评分>3、既往心肌梗死以及糖尿病会增加病假时长超过6个月的几率。
本研究表明，社会人口统计学和临床因素会影响首次择期心脏直视手术后的病假时长。术后发生中风或肾衰竭的患者病假时长超过6个月的几率最高。女性以及教育水平低、既往有心肌梗死或NYHA评分为III - IV级的患者病假时长超过6个月的几率是常人的两倍。这些研究结果有助于未来对术前和术后干预措施进行调查，以最有效地减少病假并帮助患者重返工作岗位。
