Sickness Absence following Coronary Revascularisation. A National Study of Women and Men of Working Age in Sweden 1994–2006

Q: What are the key findings of this study?

Women experienced a significantly higher prevalence of long-term sickness absence following coronary revascularisation compared to men, with a prevalence ratio of 1.23 for CABG and 1.19 for PCI.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: First coronary revascularisation (CABG or PCI) (n=63876). Intervention: Female sex vs. Male sex. Primary outcome: Long-term sickness absence (>180 days for CABG in the first sick-leave spell) (PR 1.23, 95% CI 1.19-1.28, p=<0.001).

Q: What does this research mean for the field?

Women experience a significantly higher prevalence of long-term sickness absence following coronary revascularisation compared to men, after both CABG and PCI. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To examine the incidence and determinants of long-term sickness absence among working-age women and men following a first coronary artery bypass grafting or percutaneous coronary intervention.

Margaretha Voss; Torbjörn Ivert; Kenneth Pehrsson; Niklas Hammar; Kristina Alexanderson; Tage Nilsson; Marjan Vaez

doi:10.1371/journal.pone.0040952

July 24, 2012PLoS ONEOpen Access

Sickness Absence following Coronary Revascularisation. A National Study of Women and Men of Working Age in Sweden 1994–2006

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Key result

Female sex is linked to ~23% greater long-term sickness absence after CABG compared to men.

PR 1.23
95% CI 1.19-1.28
P<0.001
n=63,876

Why the study?

What is the prevalence and gender difference in long-term sickness absence following first coronary revascularization in working-age patients?

Key Points

To examine the incidence and determinants of long-term sickness absence among working-age women and men following a first coronary artery bypass grafting or percutaneous coronary intervention.
Nationwide population-based register study in Sweden covering individuals aged 30–63 years undergoing a first CABG (n = 22,985; 16% women) or PCI (n = 40,891; 22% women) between 1994 and 2006.
Tracked long-term sickness absence (LTSA; defined as >180 days post-CABG and >90 days post-PCI) alongside linked data on comorbidity, prior sick leave, and socioeconomic status to estimate prevalence ratios (PR) with 95% confidence intervals (CI).
LTSA occurred in 41% of CABG patients and 36% of PCI patients, with women experiencing higher LTSA risk than men after CABG (PR = 1.23, 95% CI: 1.19–1.28) and after PCI (PR = 1.19, 95% CI: 1.16–1.23).
Prior sickness absence in the preceding year heightened LTSA risk in both sexes, whereas prior cardiovascular disease, diabetes, and lower socioeconomic status independently elevated LTSA risk predominantly in men.
Adjusted LTSA rates remained constant over the 13-year study period for PCI patients but increased over time for CABG patients.

Study Design

Type

Cohort (n=63,876)

Multicenter

Yes

Structured PICO

What is the prevalence and gender difference in long-term sickness absence following first coronary revascularization in working-age patients?

P

Population

63,876 working-age adults (30-63 years) who underwent a first coronary artery bypass grafting or percutaneous coronary intervention in Sweden between 1994 and 2006.

E

Exposure

First coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI)

O

Outcome

Long-term sickness absence (LTSA), defined as >180 sick-leave days in the first sick-leave spell following CABG and >90 days following PCI

Main Result

PR: 1.23 (95% CI 1.19–1.28)

Absolute Event Rate: 52.4% vs 39%

p-value: p=<0.001

Long-term sickness absence is common after coronary revascularization, particularly among women, and is influenced by prior sickness absence and socioeconomic factors.

Limitations

Only had information about sick-leave days for sick-leave spells with a duration of at least 15 days.
Information about socioeconomic position was from 1990, which was fairly old at the end of the study period.
Residual confounding may have masked some reduction in long-term sickness absence due to an increased proportion of patients with more severe disease.
Did not adjust for more effective medications and markedly reduced use of tobacco during the last decade.
No detailed information on extent of coronary artery disease in the registers.

Implication

May inform sex-tailored rehabilitation after revascularization; leaves open causal roles of biology versus socioeconomic factors.

Discussion

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Cite This Study

Voss et al. (2012) conducted a cohort in First coronary revascularisation (CABG or PCI) (n=63,876). Female sex vs. Male sex was evaluated on Long-term sickness absence (>180 days for CABG in the first sick-leave spell) (PR 1.23, 95% CI 1.19-1.28, p=<0.001). Women experienced a significantly higher prevalence of long-term sickness absence following coronary revascularisation compared to men, with a prevalence ratio of 1.23 for CABG and 1.19 for PCI.

synapsesocial.com/papers/6aa81de7ac18924c7657503d https://doi.org/10.1371/journal.pone.0040952

Topics

Percutaneous coronary intervention

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Sickness Absence following Coronary Revascularisation. A National Study of Women and Men of Working Age in Sweden 1994–2006

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Discussion

Cite This Study

Topics

Sickness Absence following Coronary Revascularisation. A National Study of Women and Men of Working Age in Sweden 1994–2006

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Discussion

Cite This Study

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