Skov Camilla Schade, Brabrand Mikkel, Mogensen Christian Backer, Skjøt-Arkil Helene, Rosenvinge Flemming Schønning, Johansen Isik Somuncu, Lassen Annmarie
Department of Emergency Medicine, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Crit Care. 2025 May 19;29(1):202. doi: 10.1186/s13054-025-05446-z.
Sepsis survivors often experience cognitive, physiological, and functional impairments that may limit return to work (RTW). We aimed to describe changes in workforce attachment among working-age patients with sepsis, both overall and stratified by treatment in general wards versus the intensive care unit (ICU). Additionally, we aimed to evaluate the impact of educational level and to identify factors associated with RTW.
A register-based cohort study including all patients aged 20-63 years with incident community-acquired sepsis admitted to a hospital in the Region of Southern Denmark between 1 January 2016 and 20 March 2018. Labour market attachment was illustrated using area charts, overall and stratified by treatment in general wards versus the ICU. Further, the overall area chart was stratified by educational level. Patients were classified as part of the workforce or non-workforce. A subgroup of the workforce comprised those working. RTW was estimated for the workforce and those working after 12, 52, 104, and 156 weeks. Factors associated with RTW were identified using cause-specific hazards.
Of the 1610 patients with sepsis included, 651 were part of the workforce, with 488 working. After 12 weeks, 69.0% of workforce patients (excluding those censored) had returned to work. This proportion increased to 81.6%, 87.5%, and 90.4% after 52, 104, and 156 weeks, respectively. Among patients working before sepsis, RTW proportions were higher. Several baseline variables and in-hospital measures were associated with RTW among the workforce including younger age (20-39 years), HR = 1.33 (95% CI, 1.05-1.68), no ICU admission, HR = 2.64 (95% CI, 1.81-3.86), lactate < 4 mmol/L, HR = 2.19 (1.13-4.24), and single organ failure, HR = 2.33 (95% CI, 1.16-4.69). While ICU admission had impact on RTW in both the workforce and those working, educational level was unrelated to RTW among those working.
Most working-age patients with sepsis were outside the workforce. Working before sepsis was the strongest predictor of RTW. While educational level influenced whether patients were part of the workforce, it was not associated with RTW among those working. No ICU admission was associated with RTW.
脓毒症幸存者常经历认知、生理和功能障碍，这可能会限制其重返工作岗位（RTW）。我们旨在描述工作年龄脓毒症患者劳动力附着情况的变化，包括总体情况以及按普通病房与重症监护病房（ICU）治疗进行分层的情况。此外，我们旨在评估教育水平的影响，并确定与RTW相关的因素。
一项基于登记的队列研究，纳入了2016年1月1日至2018年3月20日期间在丹麦南部地区一家医院收治的所有年龄在20 - 63岁的社区获得性脓毒症患者。使用面积图展示劳动力市场附着情况，总体情况以及按普通病房与ICU治疗进行分层的情况。此外，总体面积图按教育水平进行分层。患者被分类为劳动力或非劳动力。劳动力亚组包括那些有工作的人。对劳动力以及在12、52、104和156周后仍在工作的人进行RTW评估。使用特定病因风险模型确定与RTW相关的因素。
在纳入的1610例脓毒症患者中，651例属于劳动力，其中488例有工作。12周后，69.0%的劳动力患者（不包括失访者）已重返工作岗位。在52、104和156周后，这一比例分别增至81.6%、87.5%和90.4%。在脓毒症发作前有工作的患者中，RTW比例更高。包括年龄较小（20 - 39岁），HR = 1.33（95%CI，1.05 - 1.68）、未入住ICU，HR = 2.64（95%CI，1.81 - 3.86）、乳酸水平<4 mmol/L，HR = 2.19（1.13 - 4.24）以及单器官功能衰竭，HR = 2.33（95%CI，1.16 - 4.69）在内的几个基线变量和住院期间指标与劳动力中的RTW相关。虽然入住ICU对劳动力和有工作的人的RTW都有影响，但教育水平与有工作的人的RTW无关。
大多数工作年龄的脓毒症患者不属于劳动力。脓毒症发作前有工作是RTW的最强预测因素。虽然教育水平影响患者是否属于劳动力，但与有工作的人的RTW无关。未入住ICU与RTW相关。
