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Determinants of work disability following lumbar spine decompression surgery
Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.
Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.
Med Univ Vienna, Dept Social & Prevent Med, Vienna, Austria.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.ORCID iD: 0000-0002-9305-0183
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2019 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 47, no 3, p. 281-292Article in journal (Refereed) Published
Abstract [en]

Aims: Scientific knowledge about risk factors for work disability in terms of long-term sickness absence and disability pension following lumbar spine decompression surgery remains insufficient. This study aimed to investigate the associations between socio-demographic, work-related, and medical characteristics with subsequent long-term sickness absence (>90 days) and disability pension for individuals who underwent lumbar spine decompression surgery.

Methods: A prospective cohort study of all individuals aged 19-60 years with diagnosed dorsopathies, who underwent lumbar spine decompression surgery 2008-10 in Sweden (n=7373) was performed. Univariate and multivariate hazard ratios with 95% confidence intervals regarding long-term sickness absence and disability pension with a 3-year follow-up period were estimated by Cox proportional regression.

Results: Low educational level, being a non-European immigrant and preoperative sickness absence were risk factors for both long-term sickness absence and disability pension (hazard ratios: 1.2-3.8). Female sex was a risk factor for long-term sickness absence (hazard ratios: 1.3) whereas age >44 years and being a Nordic immigrant were risk factors for disability pension (hazard ratios: 1.9-2.6). Medical factors as common mental disorders, other mental disorders, prescribed psychiatric medication and somatic comorbidity were risk factors for both long-term sickness absence and disability pension (hazard ratios: 1.2-3.4). A simultaneous lumbar fusion surgery and high preoperative pain severity were risk factors for long-term sickness absence (hazard ratios 1.2-1.8).

Conclusions: To prevent long-term work disability after lumbar spine decompression surgery, specific focus is required on older and female patients, those with mental or somatic comorbidities, high levels of preoperative pain or sickness absence, with a simultaneous lumbar fusion surgery, a low educational level or a non-European immigrant background.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD , 2019. Vol. 47, no 3, p. 281-292
Keywords [en]
Dorsopathies, lumbar spine decompression surgery, lumbar fusion surgery, sick leave, disability pension, immigrants, work disability
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-383849DOI: 10.1177/1403494818785055ISI: 000466373100001PubMedID: 29974820OAI: oai:DiVA.org:uu-383849DiVA, id: diva2:1318005
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AFA Insurance, 150142Available from: 2019-05-24 Created: 2019-05-24 Last updated: 2019-05-24Bibliographically approved

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Pazarlis, Konstantinos A.

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