Author/Authors :
Laut، نويسنده , , Kristina Grّnborg and Hjort، نويسنده , , Jacob and Engstrّm، نويسنده , , Thomas and Jensen، نويسنده , , Lisette Okkels and Tilsted Hansen، نويسنده , , Hans-Henrik and Jensen، نويسنده , , Jan Skov and Pedersen، نويسنده , , Frants and Jّrgensen، نويسنده , , Erik and Holmvang، نويسنده , , Lene and Pedersen، نويسنده , , Alma Becic and Christensen، نويسنده , , Erika Frischknecht and Lippert، نويسنده , , Freddy and Lang-Jensen، نويسنده , , Torsten and Jans، نويسنده , , Henning and Hansen، نويسنده , , Poul Anders and Trautner، نويسنده , , Sven and Kristensen، نويسنده , , Steen Dalby and Lassen، نويسنده , , Jens Flensted and Lash، نويسنده , , Timothy L. and Clemmensen، نويسنده , , Peter and Terkelsen، نويسنده , , Christian Juhl، نويسنده ,
Abstract :
System delay (delay from emergency medical service call to reperfusion with primary percutaneous coronary intervention [PPCI]) is acknowledged as a performance measure in ST-elevation myocardial infarction (STEMI), as shorter system delay is associated with lower mortality. It is unknown whether system delay also impacts ability to stay in the labor market. Therefore, the aim of the study was to evaluate whether system delay is associated with duration of absence from work or time to retirement from work among patients with STEMI treated with PPCI. We conducted a population-based cohort study including patients ≤67 years of age who were admitted with STEMI from January 1, 1999, to December 1, 2011 and treated with PPCI. Data were derived from Danish population-based registries. Only patients who were full- or part-time employed before their STEMI admission were included. Association between system delay and time to return to the labor market was analyzed using a competing-risk regression analysis. Association between system delay and time to retirement from work was analyzed using a Cox regression model. A total of 4,061 patients were included. Ninety-three percent returned to the labor market during 4 years of follow-up, and 41% retired during 8 years of follow-up. After adjustment, system delay >120 minutes was associated with reduced resumption of work (subhazard ratio 0.86, 95% confidence interval 0.81 to 0.92) and earlier retirement from work (hazard ratio 1.21, 95% confidence interval 1.08 to 1.36). In conclusion, system delay was associated with reduced work resumption and earlier retirement. This highlights the value of system delay as a performance measure in treating patients with STEMI.
