Risk of a permanent work-related disability pension after incident venous thromboembolism in Denmark: A population-based cohort study.

<h4>Background</h4>Long-term complications of venous thromboembolism (VTE) hamper physical function and impair quality of life; still, it remains unclear whether VTE is associated with risk of permanent work-related disability. We aimed to assess the association between VTE and the risk...

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Autores principales:	Helle Jørgensen, Erzsébet Horváth-Puhó, Kristina Laugesen, Sigrid Brækkan, John-Bjarne Hansen, Henrik Toft Sørensen
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/1e43a84d1a4a4d57a0572d9d15671759
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spelling	oai:doaj.org-article:1e43a84d1a4a4d57a0572d9d156717592021-12-02T19:55:37ZRisk of a permanent work-related disability pension after incident venous thromboembolism in Denmark: A population-based cohort study.1549-12771549-167610.1371/journal.pmed.1003770https://doaj.org/article/1e43a84d1a4a4d57a0572d9d156717592021-08-01T00:00:00Zhttps://doi.org/10.1371/journal.pmed.1003770https://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>Long-term complications of venous thromboembolism (VTE) hamper physical function and impair quality of life; still, it remains unclear whether VTE is associated with risk of permanent work-related disability. We aimed to assess the association between VTE and the risk of receiving a permanent work-related disability pension and to assess whether this association was explained by comorbidities such as cancer and arterial cardiovascular disease.<h4>Methods and findings</h4>A Danish nationwide population-based cohort study consisting of 43,769 individuals aged 25 to 66 years with incident VTE during 1995 to 2016 and 218,845 birth year-, sex-, and calendar year-matched individuals from the general population, among whom 45.9% (N = 120,540) were women, was established using Danish national registries. The cohorts were followed throughout 2016, with permanent work-related disability pension as the outcome. Hazard ratios (HRs) with 95% confidence intervals (CIs) for disability pension were computed and stratified by sex and age groups (25 to 34, 35 to 44, 45 to 54, and 55 to 66 years of age) and adjusted for comorbidities and socioeconomic variables. Permanent work-related disability pensions were granted to 4,415 individuals with VTE and 9,237 comparison cohort members (incidence rates = 17.8 and 6.2 per 1,000 person-years, respectively). VTE was associated with a 3-fold (HR 3.0, 95% CI: 2.8 to 3.1) higher risk of receiving a disability pension. Adjustments for socioeconomic status and comorbidities such as cancer and cardiovascular diseases reduced the estimate (HR 2.3, 95% CI: 2.2 to 2.4). The risk of disability pension receipt was slightly higher in men than in women (HR 2.5, 95% CI: 2.3 to 2.6 versus HR 2.1, 95% CI: 2.0 to 2.3). As this study is based on medical and administrative registers, information on post-VTE care, individual health behavior, and workplace factors linked to disability pension in the general population are lacking. Furthermore, as disability pension schemes vary, our results might not be directly generalizable to other countries or time periods.<h4>Conclusions</h4>In this study, incident VTE was associated with increased risk of subsequent permanent work-related disability, and this association was still observed after accounting for comorbidities such as cancer and cardiovascular diseases. Our results emphasize the social consequences of VTE and may help occupational and healthcare professionals to identify vulnerable individuals at risk of permanent exclusion from the labor market after a VTE event.Helle JørgensenErzsébet Horváth-PuhóKristina LaugesenSigrid BrækkanJohn-Bjarne HansenHenrik Toft SørensenPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 18, Iss 8, p e1003770 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Helle Jørgensen Erzsébet Horváth-Puhó Kristina Laugesen Sigrid Brækkan John-Bjarne Hansen Henrik Toft Sørensen Risk of a permanent work-related disability pension after incident venous thromboembolism in Denmark: A population-based cohort study.
description	<h4>Background</h4>Long-term complications of venous thromboembolism (VTE) hamper physical function and impair quality of life; still, it remains unclear whether VTE is associated with risk of permanent work-related disability. We aimed to assess the association between VTE and the risk of receiving a permanent work-related disability pension and to assess whether this association was explained by comorbidities such as cancer and arterial cardiovascular disease.<h4>Methods and findings</h4>A Danish nationwide population-based cohort study consisting of 43,769 individuals aged 25 to 66 years with incident VTE during 1995 to 2016 and 218,845 birth year-, sex-, and calendar year-matched individuals from the general population, among whom 45.9% (N = 120,540) were women, was established using Danish national registries. The cohorts were followed throughout 2016, with permanent work-related disability pension as the outcome. Hazard ratios (HRs) with 95% confidence intervals (CIs) for disability pension were computed and stratified by sex and age groups (25 to 34, 35 to 44, 45 to 54, and 55 to 66 years of age) and adjusted for comorbidities and socioeconomic variables. Permanent work-related disability pensions were granted to 4,415 individuals with VTE and 9,237 comparison cohort members (incidence rates = 17.8 and 6.2 per 1,000 person-years, respectively). VTE was associated with a 3-fold (HR 3.0, 95% CI: 2.8 to 3.1) higher risk of receiving a disability pension. Adjustments for socioeconomic status and comorbidities such as cancer and cardiovascular diseases reduced the estimate (HR 2.3, 95% CI: 2.2 to 2.4). The risk of disability pension receipt was slightly higher in men than in women (HR 2.5, 95% CI: 2.3 to 2.6 versus HR 2.1, 95% CI: 2.0 to 2.3). As this study is based on medical and administrative registers, information on post-VTE care, individual health behavior, and workplace factors linked to disability pension in the general population are lacking. Furthermore, as disability pension schemes vary, our results might not be directly generalizable to other countries or time periods.<h4>Conclusions</h4>In this study, incident VTE was associated with increased risk of subsequent permanent work-related disability, and this association was still observed after accounting for comorbidities such as cancer and cardiovascular diseases. Our results emphasize the social consequences of VTE and may help occupational and healthcare professionals to identify vulnerable individuals at risk of permanent exclusion from the labor market after a VTE event.
format	article
author	Helle Jørgensen Erzsébet Horváth-Puhó Kristina Laugesen Sigrid Brækkan John-Bjarne Hansen Henrik Toft Sørensen
author_facet	Helle Jørgensen Erzsébet Horváth-Puhó Kristina Laugesen Sigrid Brækkan John-Bjarne Hansen Henrik Toft Sørensen
author_sort	Helle Jørgensen
title	Risk of a permanent work-related disability pension after incident venous thromboembolism in Denmark: A population-based cohort study.
title_short	Risk of a permanent work-related disability pension after incident venous thromboembolism in Denmark: A population-based cohort study.
title_full	Risk of a permanent work-related disability pension after incident venous thromboembolism in Denmark: A population-based cohort study.
title_fullStr	Risk of a permanent work-related disability pension after incident venous thromboembolism in Denmark: A population-based cohort study.
title_full_unstemmed	Risk of a permanent work-related disability pension after incident venous thromboembolism in Denmark: A population-based cohort study.
title_sort	risk of a permanent work-related disability pension after incident venous thromboembolism in denmark: a population-based cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/1e43a84d1a4a4d57a0572d9d15671759
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Risk of a permanent work-related disability pension after incident venous thromboembolism in Denmark: A population-based cohort study.

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