Work disability before and after a major cardiovascular event: a ten-year study using nationwide medical and insurance registers

Abstract

We examined the trajectories of work disability before and after IHD and stroke events. New IHD (n = 13521) and stroke (n = 7162) cases in 2006–2008 were retrieved from nationwide Swedish hospital records and their annual work disability days five years before and after the date of diagnosis were retrieved from a nationwide disability register. There was no pre-event differences in disability days between the IHD and stroke cases and five years prior to the event, they were close to those observed in the general population. In the first post-event year, the adjusted mean days increased to 83.9 (95% CI 80.6–86.5) in IHD; to 179.5 (95% CI 172.4–186.8) in stroke, a six-fold increase in IHD and 14-fold in stroke. Work disability leveled off among the IHD cases but not among those who had stroke. The highest disability levels for the fifth post-event year after a stroke event was associated with pre-existing diabetes (146.9), mental disorder (141.2), non-employment (137.0), and immigrant status (117.9). In a working-age population, the increase in work disability after a cardiovascular event decreases close to the pre-event level in IHD but remains particularly high after stroke; among patients with comorbid depression or diabetes, immigrants, and those not in employment.

Trends in Diagnosis‐Specific Work Disability Before and After Stroke: A Longitudinal Population‐Based Study in Sweden

“…However, the absolute level of work disability attributed to circulatory diagnoses still remained high after the event, and circulatory diseases remained the key work disability diagnoses, with the largest number of work disability days each year after the event (55–111 days per year among men and 56–108 days per year among women). The before‐stroke levels are comparable to those of the general population 4 years before the event, whereas after the stroke the number of work disability days per year is at a much higher level as compared with the general population during the same time period . One might also assume that age could affect the increasing trends; however, our previous study further showed that there are no notable differences between unadjusted and age‐ or education‐adjusted mean annual number of work disability days …”

“…The beforestroke levels are comparable to those of the general population 4 years before the event, whereas after the stroke the number of work disability days per year is at a much higher level as compared with the general population during the same time period. 6 One might also assume that age could affect the increasing trends; however, our previous study further showed that there are no notable differences between unadjusted and age-or education-adjusted mean annual number of work disability days. 6 In addition to circulatory diseases, there were also clear increasing and decreasing trends regarding work disability attributed to other diagnoses.…”

“…The study was conducted in the Swedish county of Östergötland, and because the number of cases was relatively low (n=212), information on sickness absence diagnoses could not be included. Additionally, in our recent study, excluding pre‐event work disability, all‐cause work disability days increased after stroke . However, information on work disability diagnoses was not examined.…”

“…Additionally, in our recent study, excluding pre-event work disability, all-cause work disability days increased after stroke. 6 However, information on work disability diagnoses was not examined. Thus, it is not known whether people who are diagnosed with stroke have an increased risk of work disability attributed to circulatory diagnoses or attributed to some other diagnoses before the stroke.…”

Work‐related predictors for return to work after stroke

“…6 Predictors for no RTW have been reported to be physical dependency at discharge, higher degree of residual disability, 11 sick leave prior to stroke, 9 unemployment prior to stroke, 12 low socio-economic status, 8 being an immigrant, 12 comorbidities, 12 older age 7 and being female. 6 Predictors for no RTW have been reported to be physical dependency at discharge, higher degree of residual disability, 11 sick leave prior to stroke, 9 unemployment prior to stroke, 12 low socio-economic status, 8 being an immigrant, 12 comorbidities, 12 older age 7 and being female.…”