The influence of socio-demographic and clinical factors on sick leave and return to work after open-heart surgery: a nationwide registry-based cohort study

Michael Mortensen; Roy M Nilsen; Venny L Kvalheim; Johannes L Bjørnstad; Øyvind S Svendsen; Rune Haaverstad; Asgjerd L Moi

doi:10.1093/ehjqcco/qcad064

The influence of socio-demographic and clinical factors on sick leave and return to work after open-heart surgery: a nationwide registry-based cohort study

Eur Heart J Qual Care Clin Outcomes. 2023 Oct 19:qcad064. doi: 10.1093/ehjqcco/qcad064. Online ahead of print.

Authors

Michael Mortensen¹, Roy M Nilsen², Venny L Kvalheim^{3

4}, Johannes L Bjørnstad^{5

6}, Øyvind S Svendsen^{7

8}, Rune Haaverstad^{3

4}, Asgjerd L Moi^{1

2

3

4

5

9

6

7

8

10}

Affiliations

¹ Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
² Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway.
³ Department of Cardiothoracic Surgery, Haukeland University Hospital, Bergen, Norway.
⁴ Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway.
⁵ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
⁶ Norwegian Register for Cardiac Surgery, Oslo, Norway.
⁷ Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.
⁸ Department of Clinical Medicine, University of Bergen, Norway.
⁹ Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway.
¹⁰ Faculty of Health Sciences, VID Specialized University, Bergen, Norway.

PMID: 37858302
DOI: 10.1093/ehjqcco/qcad064

Abstract

Aims: To estimate sick leave (SL) duration after first-time elective open-heart surgery and identify factors contributing to increased SL.

Methods and results: A retrospective nationwide cohort study combined data from the Norwegian Register for Cardiac Surgery and SL data from the Norwegian Labour and Welfare Administrations. All able-bodied adults who underwent first-time elective open-heart surgery in Norway between 2012 and 2021 were followed until one year after surgery. The impact of socio-demographic and clinical factors on SL after surgery was analysed using logistic regression and odds ratios. Of 5456 patients, 1643 (30.1%), 1798 (33.0%), 971 (17.8%), 1035 (18.9%), and 9 (0.2%) had SL of <3, 3-6, 6-9, and 9-12 months, and one year, respectively. SL > 6 months was associated with female gender, primary education only, and average annual income. Postoperative stroke, postoperative renal failure, New York Heart Association Functional Classification system (NYHA) score > 3, earlier myocardial infarction, and diabetes mellitus increased the odds of SL > 6 months.

Conclusion: This study demonstrates that socio-demographic and clinical factors impact SL after first-time elective open-heart surgery. Patients who experience a stroke or develop renal failure after surgery have the highest odds of SL > 6 months. Females and patients with low education levels, earlier myocardial infarction, or NYHA scores III-IV have a twofold chance of SL > 6 months. The findings allow for future investigations of pre- and post-surgery interventions that can most effectively reduce SL and aid return to work.