title: [Pre-surgical period and non-work-related sickness absence due to inguinal hernia].
abstract: OBJECTIVE
  To analyze non-work-related sickness absence (NWR-SA) due to inguinal hernia and the factors related to its duration, paying particular attention to the pre-surgical period of NWR-SA.
  
  
  METHODS
  Prospective cohort study was conducted on 1,003 workers with an episode of NWR-SA due to an inguinal hernia, belonging to the insured population of a mutual insurance company. We assessed the duration of the NWR-SA episodes and the main demographic, occupational and clinical variables potentially related to it. Cox regression analyses were conducted to establish the predictors of NWR-SA duration.
  
  
  RESULTS
  The mean duration of NWR-SA due to inguinal hernia was 68.6 days. After multivariate analysis (Cox regression), having a pre-surgical period of NWR-SA (HR = 0.35; 95%CI: 0.28-0.43), manual occupations (HR=0.68; 95%CI: 0.49-0.95), construction sector (HR=0.71; 95%CI: 0.58-0.88), direct payment methods by a Mutual Insurance Company during sick leave in self-employed workers (HR=0.58; 95%CI, 0.41-0.82), or employees (HR=0.51; 95%CI: 0.36-0.72), comorbidity (HR=0.45; 95%CI:0.34-0.59), and surgery performed under an entity other than the Public Health System or a mutual insurance company (HR=0,76; 95%CI: 0.59-0.97) were associated with longer NWR-SA. The Mutual Insurance Company always performed the surgery when a pre-surgery period of NWR-SA existed (mean duration=47 ±39.6 days); that was associated with shorter periods of post-surgical NWR-SA (P=.001).
  
  
  CONCLUSIONS
  The NWR-SA due to inguinal hernia is a multifactorial phenomenon in which the pre-surgery period plays an important role. The collaboration between organizations involved in the management of NWR-SA seems to be an effective strategy for reducing its duration.
authors.affiliation: Ibermutuamur (Mutua de accidentes de trabajo y enfermedades profesionales de la Seguridad Social n.° 274), Madrid, España.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Ruiz-Moraga
authors.affiliation: Ibermutuamur (Mutua de accidentes de trabajo y enfermedades profesionales de la Seguridad Social n.° 274), Madrid, España. Electronic address: carloscatalina@ibermutuamur.es.
authors.forename: Carlos
authors.initials: C
authors.lastname: Catalina-Romero
authors.affiliation: Ibermutuamur (Mutua de accidentes de trabajo y enfermedades profesionales de la Seguridad Social n.° 274), Madrid, España.
authors.forename: Paloma
authors.initials: P
authors.lastname: Martínez-Muñoz
authors.affiliation: Ibermutuamur (Mutua de accidentes de trabajo y enfermedades profesionales de la Seguridad Social n.° 274), Madrid, España.
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Cobo-Santiago
authors.affiliation: Ibermutuamur (Mutua de accidentes de trabajo y enfermedades profesionales de la Seguridad Social n.° 274), Madrid, España.
authors.forename: Maite
authors.initials: M
authors.lastname: González-López
authors.affiliation: Ibermutuamur (Mutua de accidentes de trabajo y enfermedades profesionales de la Seguridad Social n.° 274), Madrid, España.
authors.forename: Martha
authors.initials: M
authors.lastname: Cabrera-Sierra
authors.affiliation: Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Santa Cristina, Madrid, España.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Porrero-Carro
authors.affiliation: Ibermutuamur (Mutua de accidentes de trabajo y enfermedades profesionales de la Seguridad Social n.° 274), Madrid, España.
authors.forename: Eva
authors.initials: E
authors.lastname: Calvo-Bonacho
mesh_terms: D000328:Adult; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018582:Sick Leave; D013997:Time Factors; D055815:Young Adult
keywords: Ausencia por enfermedad; Gestión en salud; Health management; Hernia inguinal; Inguinal hernia; Sick leave