Von Korff M, Stewart W F, Simon D J, Lipton R B
Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA 98101, USA.
Neurology. 1998 Jun;50(6):1741-5. doi: 10.1212/wnl.50.6.1741.
This article estimates lost work days and lost work day equivalents in a population sample of migraineurs, differentiating work loss due to headache episodes that met criteria for migraine from migrainous headaches not meeting full criteria and nonmigrainous headaches.
A random digit dialing survey of 5,071 adults identified 800 subjects with migraine headaches. By clinical examination, a subsample of 225 met migraine diagnostic criteria; 174 of these patients completed at least 11 weeks of daily diaries. This report concerns the subgroup of 122 individuals with regular paid employment. Subjects completed a daily diary over a 3-month period to assess the occurrence of headaches and International Headache Society (IHS) criteria for each headache occurrence. We report estimates of lost work days and lost work day equivalents by type of headache.
Participants reported headaches on 8.1 work days, of which 2.2 headache days met criteria for migraine (IHS 1.1, 1.2), and an additional 2.1 headache days were migrainous without meeting full migraine criteria (IHS 1.7). On average, migraineurs missed 1.1 days of work due to headache in 3 months, of which 0.7 lost work days were due to migraine and 0.3 were due to migrainous headaches. When at work with headache, work effectiveness was reduced 41% for migraine headaches, 28% for migrainous headaches, and 24% for other headaches. Over 3 months, migraineurs experienced an average of 3.0 lost work day equivalents, of which 1.4 were due to migraine and an additional 0.7 were due to migrainous headaches. The most disabled 20% of the participants accounted for 77% of the lost work days; 40% of subjects accounted for 75% of the lost work day equivalents.
Employed migraine sufferers experienced considerable work loss and reduced work performance due to headache. The most severely affected migraineurs accounted for most of the reduced work performance. Targeting the most severely affected persons may be necessary to reduce work loss among migraineurs substantially.
本文对偏头痛患者群体样本中的误工天数及等效误工天数进行了估算，区分了符合偏头痛标准的头痛发作导致的误工与未达完整标准的偏头痛性头痛及非偏头痛性头痛导致的误工情况。
对5071名成年人进行随机数字拨号调查，识别出800名偏头痛患者。通过临床检查，225名患者的子样本符合偏头痛诊断标准；其中174名患者完成了至少11周的每日日记记录。本报告关注的是122名有正规带薪工作的个体亚组。受试者在3个月内完成每日日记，以评估头痛的发生情况以及每次头痛发作的国际头痛协会（IHS）标准。我们按头痛类型报告了误工天数及等效误工天数的估算值。
参与者报告在8.1个工作日出现头痛，其中2.2个头痛日符合偏头痛标准（IHS 1.1、1.2），另外2.1个头痛日为偏头痛性头痛但未达完整偏头痛标准（IHS 1.7）。平均而言，偏头痛患者在3个月内因头痛误工1.1天，其中0.7天的误工是由偏头痛导致的，0.3天是由偏头痛性头痛导致的。头痛时工作，偏头痛性头痛导致工作效率降低41%，偏头痛性头痛导致降低28%，其他头痛导致降低24%。在3个月期间，偏头痛患者平均经历3.0个等效误工天数，其中1.4个是由偏头痛导致的，另外0.7个是由偏头痛性头痛导致的。最严重残疾的20%参与者占误工天数的77%；40%的受试者占等效误工天数的75%。
有工作的偏头痛患者因头痛经历了相当多的误工及工作表现下降。受影响最严重的偏头痛患者占工作表现下降的大部分。为大幅减少偏头痛患者的误工情况，可能有必要针对受影响最严重的人群。
