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Permanent work disability before and after ischaemic heart disease or stroke event: a nationwide population-based cohort study in Sweden.
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2017 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 9, article id e017910Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: We examined the risk of disability pension before and after ischaemic heart disease (IHD) or stroke event, the burden of stroke compared with IHD and which factors predicted disability pension after either event.

DESIGN: A population-based cohort study with follow-up 5 years before and after the event. Register data were analysed with general linear modelling with binary and Poisson distributions including interaction tests for event type (IHD/stroke).

SETTING AND PARTICIPANTS: All people living in Sweden, aged 25‒60 years at the first event year, who had been living in Sweden for 5 years before the event and had no indication of IHD or stroke prior to the index event in 2006‒2008 were included, except for cases in which death occurred within 30 days of the event. People with both IHD and stroke were excluded, resulting in 18 480 cases of IHD (65%) and 9750 stroke cases (35%).

PRIMARY OUTCOME MEASURES: Disability pension.

RESULTS: Of those going to suffer IHD or stroke event, 25% were already on disability pension a year before the event. The adjusted OR for disability pension at first postevent year was 2.64-fold (95% CI 2.25 to 3.11) for people with stroke compared with IHD. Economic inactivity predicted disability pension regardless of event type (OR=3.40; 95% CI 2.85 to 4.04). Comorbid mental disorder was associated with the greatest risk (OR=3.60; 95% CI 2.69 to 4.83) after an IHD event. Regarding stroke, medical procedure, a proxy for event severity, was the largest contributor (OR=2.27, 95% CI 1.43 to 3.60).

CONCLUSIONS: While IHD event was more common, stroke involved more permanent work disability. Demographic, socioeconomic and comorbidity-related factors were associated with disability pension both before and after the event. The results help occupational and other healthcare professionals to identify vulnerable groups at risk for permanent labour market exclusion after such an event.

Place, publisher, year, edition, pages
2017. Vol. 7, no 9, article id e017910
Keywords [en]
Cardiovascular disease, Cohort studies, Disability pension, Ischaemic heart disease, Occupational Health, Sick leave, Stroke
National Category
Neurology
Identifiers
URN: urn:nbn:se:uu:diva-348518DOI: 10.1136/bmjopen-2017-017910PubMedID: 28965101OAI: oai:DiVA.org:uu-348518DiVA, id: diva2:1197852
Available from: 2018-04-15 Created: 2018-04-15 Last updated: 2018-05-16Bibliographically approved

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