scholarly journals Kjønnsforskjeller i overgang fra langtidssykmelding til uførepensjon i 1997-2002

2010 ◽  
Vol 19 (2) ◽  
Author(s):  
Sturla Gjesdal
Keyword(s):  
Gender Differences ◽  
Sick Leave ◽  
Sickness Absence ◽  
Disability Pension ◽  
Proportional Hazards ◽  
Sociodemographic Factors ◽  
Cox Proportional Hazards ◽  
Research Database ◽  
Permanent Disability

<p><strong><em>Bakgrunn: </em></strong>Denne studien undersøker overgangen fra langtidssykmelding til uførepensjonering for å se om man her kan finne noe av forklaringen på den observerte overhyppighet av uførepensjonering blant kvinner.</p><p><strong><em>Metode og materiale: </em></strong>Prospektiv nasjonal kohortstudie som inkluderer 66 083 kvinner og 47 073 menn i alderen 16-62 år som var sykmeldt lenger enn åtte uker i 1997. Data er hentet fra FD-trygd. Kvinner som var sykmeldt med en W-diagnose (svangerskapsrelatert) ble ekskludert fra analysen pga alder og lav uførefrekvens. Kohorten ble fulgt opp i fem år med overgang til uførepensjon som endepunkt. Betydning av kjønn ble estimert ved hjelp av Cox' proporsjonal hasards analyse, kontrollert for sosiodemografiske faktorer. Vi gjorde separate analyser for de sykmeldte med muskel- og skjelettdiagnoser, psykiske diagnoser, hjerte/lungediagnoser og "andre" sykmeldingsdiagnoser, også med stratifisering for bostedsfylke.</p><p><strong><em>Resultater: </em></strong>22% av de sykmeldte mennene og 24% av kvinnene var uførepensjonert etter fem års oppfølging. Etter justering for sosiodemografiske faktorer var risiko for uførepensjon fortsatt høyere for kvinner med muskel- og skjelettdiagnoser, men høyere for menn i de andre diagnosegruppene og totalt.</p><p><strong><em>Konklusjon: </em></strong>Risiko for uførepensjon blant langtidssykmeldte kvinner er ikke høyere enn hos langtidssykmeldte menn. Tvert imot, etter korreksjon for sosiodemografiske variabler, er det langtidssykmeldte menn som har størst risiko for å bli uførepensjonert, særlig innen gruppen som var sykmeldt for en psykisk lidelse. Siden langtidssykefraværet er høyere blant kvinner enn blant menn, er likevel totaleffekten en større uføretilgang blant kvinnelige langtidssykmeldte.</p><p> </p><p>Gjesdal S. <strong>Gender differences in transition from long-term sickness absence to permanent disability pension, 1997-2002. </strong><em>Nor J Epidemiol </em>2009; <strong>19 </strong>(2): 193-202.</p><p><strong> </strong></p><p><strong>E</strong><strong>NGLISH SUMMARY</strong></p><p><strong><em>Background: </em></strong>The study investigates the transition from long-term sickness absence to permanent disability pension (DP) in Norway. The aim is to assess whether gender differences in this process explain the observed female excess in disability pensioning in Norway.</p><p><strong><em>Methods and data: </em></strong>Prospective national cohort study including 66,083 women and 47,073 men aged 16-62 years, with a spell of sick leave longer than 8 weeks in 1997. The data is obtained from a national research database (FD-trygd). Women on sick leave with a pregnancy related diagnosis were excluded. The endpoint was granting of a DP. The effect of gender on the risk of obtaining a DP was estimated by means of Cox' proportional hazards analysis, adjusted for sociodemographic factors. Separate analyses were carried out for those with diagnoses indicating diseases in the musculoskeletal, mental, and cardiovascular and respiratory groups combined. Stratified analyses for county of residence were also performed.</p><p><strong><em>Results: </em></strong>22% of the male and 24% of the female sample obtained a DP during follow-up. Adjusted for sociodemographic factors the risk of DP was still higher for women with musculoskeletal diagnoses, but higher for men in the remaining diagnostic groups and overall.</p><p><strong><em>Conclusion: </em></strong>The risk of DP after sickness absence is not higher in women compared to men. On the contrary, after adjustment for relevant sociodemographic variables, men on sick-leave have the highest risk of a future DP. This is most evident among those on sick-leave with a mental diagnosis. However, since longterm sickness absence is much more frequent among women, the total effect is a higher rate of DP among Norwegian women.</p>

scholarly journals Role of social benefits for future long-term sickness absence, disability pension and unemployment among individuals on sickness absence due to mental diagnoses: a competing risk approach

2021 ◽  
Author(s):  
Annina Ropponen ◽  
Jurgita Narusyte ◽  
Mo Wang ◽  
Sanna Kärkkäinen ◽  
Lisa Mather ◽  
...  
Keyword(s):  
Sickness Absence ◽  
Cumulative Incidence ◽  
Disability Pension ◽  
Social Insurance ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Social Benefits

Abstract Purpose To investigate associations between social benefits and disability pension (DP), long-term sickness absence (LTSA, ≥ 90 days), or unemployment among Swedish twins with sickness absence (SA) due to mental diagnoses. Methods This population-based prospective twin study included register data on first incident SA spell (< 90 days) due to mental diagnoses (ICD 10 codes F00-F99) during the follow-up 2005–2016. SA < 90 days due to other diagnoses than mental diagnoses or any other social insurance benefit was identified for the preceding year of the first incident SA spell due to mental diagnoses (coded yes/no). Comparing those with any previous social benefits vs without, cumulative incidence curve to compare time to an event, and Cox proportional hazards models for cause-specific hazard ratios (HR, 95% confidence intervals, CI) treating first incident DP, LTSA and unemployment as competing risks were modeled. Results During follow-up, 21 DP, 1619 LTSA, and 808 unemployment events took place. Compared to those without, those with at least one benefit had a higher risk for DP (HR 5.03; 95%CI 1.80, 14.01), LTSA (1.67; 1.50, 1.84) and unemployment (1.24; 1.03, 1.50). The cumulative incidence for DP was very low, < 1%, for LTSA 80% with any previous social benefits vs. 60% without, and for unemployment ≤ 5%. Conclusion Social benefits received during the preceding year of SA due to mental diagnoses (< 90 days) predict DP, LTSA, and unemployment. Hence, previous social benefits may provide means for early identification of persons at risk for exit from labor market.

scholarly journals Suicide attempt following sickness absence and disability pension due to common mental disorders: a prospective Swedish twin study

2019 ◽  
Vol 55 (8) ◽  
pp. 1053-1060 ◽  
Author(s):  
M. Wang ◽  
L. Mather ◽  
P. Svedberg ◽  
E. Mittendorfer-Rutz
Keyword(s):  
Mental Disorders ◽  
Suicide Attempt ◽  
Sickness Absence ◽  
Disability Pension ◽  
Depressive Disorders ◽  
Proportional Hazards ◽  
Common Mental Disorders ◽  
Cox Proportional Hazards ◽  
Shared Environment ◽  
Familial Factors

Abstract Purpose The aim of this study was to investigate if sickness absence and disability pension (SA/DP) in general and due to specific common mental disorders (CMDs) are associated with subsequent suicide attempt among women and men by taking familial factors (genetics and shared environment) into consideration. Methods This register-based cohort study includes 4871 twin pairs 18–65 years of age discordant for SA/DP due to CMDs 2005–2010. Twins were followed up for suicide attempt from inpatient and specialised outpatient care until December 2012. Conditional Cox proportional hazards regression models, adjusting for familial factors, were used to calculate hazard ratios (HR) with 95% confidence intervals (CI). Results SA/DP due to CMDs was associated with a higher risk of suicide attempt (HR 3.14, CI 2.51–3.93). The risk of suicide attempt was five times higher among men and three times higher among women, compared to the SA/DP unaffected co-twins. In the diagnosis-specific analysis, SA/DP due to anxiety disorders resulted in the highest HR (4.09, CI 2.37–7.06) for suicide attempt, followed by depressive disorders (HR 3.70, CI 2.66–5.14) and stress-related disorders (HR 1.96, CI 1.35–2.84). The stratified analysis on zygosity indicates that there seems to be a genetic influence on the associations between SA/DP due to CMDs and suicide attempt, particularly among women and among those with SA/DP due to depressive disorders. Conclusions SA/DP due to CMDs was a risk factor for suicide attempt among women and men. Genetic factors might explain part of the associations for women and for those with SA/DP due to depressive disorders.

Sickness absence and disability pension in a cohort of employees initially on long-term sick leave due to psychiatric disorders in Sweden

2007 ◽  
Vol 42 (5) ◽  
pp. 381-388 ◽  
Author(s):  
Marjan Vaez ◽  
Gunnar Rylander ◽  
Åke Nygren ◽  
Marie Åsberg ◽  
Kristina Alexanderson
Keyword(s):  
Sick Leave ◽  
Psychiatric Disorders ◽  
Sickness Absence ◽  
Disability Pension

scholarly journals Long-Term Use of Statins Lowering the Risk of Rehospitalization Caused by Ischemic Stroke Among Middle-Aged Hyperlipidemic Patients: A Population-Based Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Jiu-Haw Yin ◽  
Giia-Sheun Peng ◽  
Kang-Hua Chen ◽  
Chi-Ming Chu ◽  
Wu-Chien Chien ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Proportional Hazards ◽  
Population Based ◽  
Drug Dosage ◽  
Cox Proportional Hazards ◽  
Lipid Lowering ◽  
Research Database ◽  
Protective Effects ◽  
Long Term Effects

Background: The long-term effects of statin use on rehospitalization due to ischemic stroke (reHospIS) in hyperlipidemic patients are still unknown. Therefore, we aimed to assess the long-term risks of reHospIS for hyperlipidemic patients who were taking statins and nonstatin lipid-lowering medicines on a regular basis.Methods and Materials: The National Health Insurance Research Database in Taiwan was used to conduct a 6-year cohort study of patients &gt;45 years old (n = 9,098) who were newly diagnosed with hyperlipidemia and hospitalized for the first or second time due to ischemic stroke (IS). The risk of reHospIS was assessed using Cox proportional hazards regression model.Results: Nonstatin lipid-lowering medicines regular users were associated with a higher risk of reHospIS compared to stains users (hazard ratio, HR = 1.29–1.39, p &lt; 0.05). Rosuvastatin was the most preferred lipid-lowering medicine with lower HRs of reHospIS in hyperlipidemic patients whether they developed diabetes or not. Bezafibrate regular users of hyperlipidemic patients developing diabetes (HR = 2.15, p &lt; 0.01) had nearly 50% lower reHospIS risks than those without diabetes (HR = 4.27, p &lt; 0.05). Age, gender, drug dosage, comorbidities of diabetes and heart failure (HF), and characteristics of the first hospitalization due to IS were all adjusted in models. Moreover, increasing trends of HRs of reHospIS were observed from Rosuvastatin, nonstatin lipid-lowering medicines, Lovastatin, and Gemfibrozil to Bezafibrate users.Conclusion: Statins were associated with long-term secondary prevention of reHospIS for hyperlipidemic patients. Rosuvastatin seemed to have the best protective effects. On the other hand, Bezafibrate appears to be beneficial for hyperlipidemic patients developing diabetes. Further research into the combination treatment of statin and nonstatin lipid-lowering medicines in hyperlipidemic patients developing diabetes is warranted.

scholarly journals Transitioning from sickness absence to disability pension—the impact of poor health behaviours: a prospective Swedish twin cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031889 ◽  
Author(s):  
Björg Helgadóttir ◽  
Lisa Mather ◽  
Jurgita Narusyte ◽  
Annina Ropponen ◽  
Victoria Blom ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cohort Study ◽  
Sickness Absence ◽  
Disability Pension ◽  
Proportional Hazards ◽  
Health Behaviours ◽  
Current Smoker ◽  
Cox Proportional Hazards ◽  
Poor Health ◽  
The Impact

ObjectivesTo investigate the association between three poor health behaviours (current smoker, high consumption of alcohol and low physical activity levels) and the transition to disability pension (DP) among individuals who have recently been sickness absent. Furthermore, we aimed to explore whether having multiple poor health behaviours increased the risk of transitioning from sickness absence (SA) to DP.DesignProspective twin cohort study.SettingSweden.ParticipantsTwins aged 20–46 who had participated in a survey and been on SA (>14 days) in the year preceding baseline (date of answering the questionnaire).Main outcome measureIncident DP during the follow-up which ended on 31 December 2012 (mean 5.2 years). A national register with full coverage provided data on DP.ResultsThe Cox proportional-hazards regression analyses showed that current smokers had a higher risk of transitioning from SA to DP compared with never smokers (HR 1.76; 95% CI 1.08 to 2.84). Alcohol use and lack of physical activity as well as poor health behaviour sum score showed no significant associations.ConclusionsBeing a current smoker influences the transition from SA to DP. Although non-significant, there were indications that more physical activity and fewer poor health behaviours could reduce the risk of exiting the labour market through DP. Improving health behaviours among people on SA could be a valuable tool for preventing the transition to DP.

scholarly journals Perioperative Geriatric Assessment as A Predictor of Long-Term Hepatectomy Outcomes in Elderly Patients with Hepatocellular Carcinoma

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 842
Author(s):  
Masaki Kaibori ◽  
Hideyuki Matsushima ◽  
Morihiko Ishizaki ◽  
Hisashi Kosaka ◽  
Kosuke Matsui ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Geriatric Assessment ◽  
Proportional Hazards ◽  
Prognostic Indicator ◽  
Cox Proportional Hazards ◽  
Rate Of Change ◽  
Score Change ◽  
Comorbidity Burden ◽  
Reduction Group

This retrospective study recorded pertinent baseline geriatric assessment variables to identify risk factors for recurrence-free survival (RFS) and overall survival (OS) after hepatectomy in 100 consecutive patients aged ≥70 years with hepatocellular carcinoma. Patients had geriatric assessments of cognition, nutritional and functional statuses, and comorbidity burden, both preoperatively and at six months postoperatively. The rate of change in each score between preoperative and postoperative assessments was calculated by subtracting the preoperative score from the score at six months postoperatively, then dividing by the score at six months postoperatively. Patients with score change ≥0 comprised the maintenance group, while patients with score change <0 comprised the reduction group. The change in Geriatric 8 (G8) score at six months postoperatively was the most significant predictive factor for RFS and OS among the tested geriatric assessments. Five-year RFS rates were 43.4% vs. 6.7% (maintenance vs. reduction group; HR, 0.19; 95%CI, 0.11–0.31; p < 0.001). Five-year OS rates were 73.8% vs. 17.8% (HR, 0.12; 95%CI, 0.06–0.25; p < 0.001). Multivariate Cox proportional hazards analysis showed that perioperative maintenance of G8 score was an independent prognostic indicator for both RFS and OS. Perioperative changes in G8 scores can help forecast postoperative long-term outcomes in these patients.

scholarly journals The incidence of mental disorder increases after hip fracture in older people: a nationwide cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ling-Yin Kuo ◽  
Po-Ting Hsu ◽  
Wen-Tien Wu ◽  
Ru-Ping Lee ◽  
Jen-Hung Wang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Geriatric Patients ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Control Group ◽  
Research Database ◽  
Fracture Group ◽  
Related Risk ◽  
And Control

Abstract Background People living with dementia seem to be more likely to experience delirium following hip fracture. The association between mental disorders (MD) and hip fracture remains controversial. We conducted a nationwide study to examine the prevalence of MD in geriatric patients with hip fractures undergoing surgery and conducted a related risk factor analysis. Material and methods This retrospective cohort study used data from Taiwan’s National Health Insurance Research Database between 2000 and 2012 and focused on people who were older than 60 years. Patients with hip fracture undergoing surgical intervention and without hip fracture were matched at a ratio of 1:1 for age, sex, comorbidities, and index year. The incidence and hazard ratios of age, sex, and multiple comorbidities related to MD and its subgroups were calculated using Cox proportional hazards regression models. Results A total of 1408 patients in the hip fracture group and a total of 1408 patients in the control group (no fracture) were included. The overall incidence of MD for the hip fracture and control groups per 100 person-years were 0.8 and 0.5, respectively. Among MD, the incidences of transient MD, depression, and dementia were significantly higher in the hip fracture group than in the control group. Conclusions The prevalence of newly developed MD, especially transient MD, depression, and dementia, was higher in the geriatric patients with hip fracture undergoing surgery than that in the control group. Prompt and aggressive prevention protocols and persistent follow-up of MD development is highly necessary in this aged society.

scholarly journals Sickness absence and disability pension after carpal tunnel syndrome diagnosis: A register-based study of patients and matched references in Sweden

2021 ◽  
pp. 140349482110027
Author(s):  
Tea Lallukka ◽  
Rahman Shiri ◽  
Kristina Alexanderson ◽  
Jenni Ervasti ◽  
Ellenor Mittendorfer-Rutz ◽  
...  
Keyword(s):  
Health Care ◽  
Carpal Tunnel Syndrome ◽  
Sickness Absence ◽  
Carpal Tunnel ◽  
Disability Pension ◽  
Negative Binomial ◽  
Age Groups ◽  
Negative Binomial Regression ◽  
Sociodemographic Factors ◽  
Tunnel Syndrome

Aims: The aim of this study was to examine sickness absence and disability pension (SA/DP) during working lifespan among individuals diagnosed with carpal tunnel syndrome (CTS) and their matched references, accounting for sociodemographic factors. Methods: We used a register cohort of 78,040 individuals aged 19–60 years when diagnosed with CTS in secondary health care (hospitals and outpatient specialist health care) and their 390,199 matched references from the general population in 2001–2010. Sociodemographic factors and SA/DP net days during a three-year follow-up were included. Negative binomial regression was used. Results: For those not on DP at inclusion, the average number of SA/DP days per person-year was 58 days (95% confidence interval (CI) 56–60 days) among individuals with CTS and 20 days (95% CI 19–21 days) among the matched references. Among both groups, these numbers increased with age and were higher among women than among men. The rate ratio (RR) of SA/DP days was threefold higher among people with CTS than among the matched references (adjusted RR=3.00, 95% CI 2.91–3.10) Moreover, compared to the matched references, the RR for SA/DP was higher among men with CTS (RR=3.86, 95% CI 3.61–4.13) than among women with CTS (RR=2.69, 95% CI 2.59–2.78). The association between CTS and the number of SA/DP days was smaller among older age groups. Sociodemographic factors were similarly associated with SA/DP among people with and without CTS. Conclusions: Numbers of SA/DP days were higher among people with CTS than their matched references in all age groups, particularly among individuals in their early work careers, highlighting public-health relevance of the findings.

Reduction in Short- and Long-term Pneumonia Rate With Laryngoplasty for Unilateral Vocal Fold Paralysis

2021 ◽  
pp. 019459982110151
Author(s):  
Cheng-Ming Hsu ◽  
Yao-Te Tsai ◽  
Geng-He Chang ◽  
Yao-Hsu Yang ◽  
Tuan-Jen Fang ◽  
...  
Keyword(s):  
Lower Incidence ◽  
Vocal Fold ◽  
Proportional Hazards ◽  
Vocal Fold Paralysis ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Voice Therapy ◽  
Unilateral Vocal Fold Paralysis ◽  
Short And Long Term

Objective To examine the association of laryngoplasty, voice therapy, and pneumonia rate in patients with unilateral vocal fold paralysis (UVFP). Study Design Population-based retrospective cohort study. Setting Data were collected from the LHID2000 (Longitudinal Health Insurance Database 2000), containing the information of 1 million randomly selected patients in Taiwan. Methods In the LHID2000, we identified 439 patients having new diagnoses of UVFP from 1997 to 2013. We grouped the aforementioned patients according to UVFP treatment and probed the occurrence of pneumonia: 305 patients underwent laryngoplasty or voice therapy, and 134 patients did not undergo treatment. Follow-up procedures were executed for the enrollees until death or December 31, 2013, representing the end of the study period. We assessed the association of UVFP treatment and pneumonia by executing Cox proportional hazards regression. Results The pneumonia cumulative incidence was significantly higher among enrolled patients without treatment than in those receiving treatment ( P < .001). The pneumonia incidence was significantly lower in patients receiving UVFP treatment (hazard ratio, 0.49; 95% CI, 0.27-0.88; P = .018), as validated by the Cox proportional hazards model after adjustment. Patients undergoing laryngoplasty with or without voice therapy had a significantly lower incidence of pneumonia at 6 months and 1, 3, and 5 years, whereas those undergoing voice therapy alone did not. Conclusion Laryngoplasty was associated with a lower incidence of short- and long-term pneumonia in patients with UVFP. Physicians should encourage patients with UVFP at risk of aspiration to receive prompt evaluation as well as treatment.

Inter-pregnancy interval and later pediatric cardiovascular health of the offspring – a population-based cohort study

2020 ◽  
pp. 1-5
Author(s):  
Majdi Imterat ◽  
Tamar Wainstock ◽  
Eyal Sheiner ◽  
Gali Pariente
Keyword(s):  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Cardiovascular Morbidity ◽  
Cox Proportional Hazards Model ◽  
Hazards Model ◽  
Kaplan Meier ◽  
Inter Pregnancy Interval

Abstract Recent evidence suggests that a long inter-pregnancy interval (IPI: time interval between live birth and estimated time of conception of subsequent pregnancy) poses a risk for adverse short-term perinatal outcome. We aimed to study the effect of short (<6 months) and long (>60 months) IPI on long-term cardiovascular morbidity of the offspring. A population-based cohort study was performed in which all singleton live births in parturients with at least one previous birth were included. Hospitalizations of the offspring up to the age of 18 years involving cardiovascular diseases and according to IPI length were evaluated. Intermediate interval, between 6 and 60 months, was considered the reference. Kaplan–Meier survival curves were used to compare the cumulative morbidity incidence between the groups. Cox proportional hazards model was used to control for confounders. During the study period, 161,793 deliveries met the inclusion criteria. Of them, 14.1% (n = 22,851) occurred in parturient following a short IPI, 78.6% (n = 127,146) following an intermediate IPI, and 7.3% (n = 11,796) following a long IPI. Total hospitalizations of the offspring, involving cardiovascular morbidity, were comparable between the groups. The Kaplan–Meier survival curves demonstrated similar cumulative incidences of cardiovascular morbidity in all groups. In a Cox proportional hazards model, short and long IPI did not appear as independent risk factors for later pediatric cardiovascular morbidity of the offspring (adjusted HR 0.97, 95% CI 0.80–1.18; adjusted HR 1.01, 95% CI 0.83–1.37, for short and long IPI, respectively). In our population, extreme IPIs do not appear to impact long-term cardiovascular hospitalizations of offspring.

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