The effect of community-acquired bacteraemia on return to workforce, risk of sick leave, permanent disability pension and death: a Danish population-based cohort study.
OBJECTIVE
Little is known about the prognosis of community-acquired bacteraemia (CAB) in workforce adults. We assessed return to workforce, risk for sick leave, disability pension and mortality within 1 year after CAB in workforce adults compared with blood culture-negative controls and population controls.


METHODS
Population-based cohort study.


METHODS
North Denmark, 1996-2011.


METHODS
We used population-based healthcare registries to identify all patients aged 20-58 years who had first-time blood cultures obtained within 48 h of medical hospital admission, and who were part of the workforce (450 bacteraemia exposed patients and 6936 culture-negative control patients). For each bacteraemia patient, we included up to 10 matched population controls.


METHODS
Return to workforce, risk of sick leave, permanent disability pension and mortality within 1 year after bacteraemia. Regression analyses were used to compute adjusted relative risks (RRs) with 95% CIs.


RESULTS
One year after admission, 78% of patients with CAB, 85.7% of culture-negative controls and 96.8% of population controls were alive and in the workforce, and free from sick leave or disability pension. Compared with culture-negative controls, bacteraemia was associated with an increased risk for long-term sick leave (4-week duration, 40.2% vs 23.9%, adjusted RR, 1.51; CI 1.34 to 1.70) and an increased risk for mortality (30-day mortality, 4% vs 1.4%, adjusted RR, 2.34, CI 1.22 to 4.50; 1-year mortality, 8% vs 3.9%, adjusted RR, 1.73; CI 1.18 to 2.55). Bacteraemia patients had a risk for disability pension similar to culture-negative controls (2.7% vs 2.6%, adjusted RR, 0.99, CI 0.48 to 2.02) but greater than population controls (adjusted RR, 5.20; 95% CI 2.16 to 12.50).


CONCLUSIONS
CAB is associated with long duration of sick leave and considerable mortality in working-age adults when compared with blood culture-negative controls, and an increased 1-year risk for disability pension when compared with population controls.
Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
Michael
M
Dalager-Pedersen
Kristoffer
K
Koch
Reimar Wernich
RW
Thomsen
Henrik Carl
HC
Schønheyder
Henrik
H
Nielsen
D000328:Adult; D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000453:epidemiology; D003718:Denmark / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011159:Population Surveillance; D020127:Recovery of Function; D012042:Registries; D018570:Risk Assessment; D018582:Sick Leave / Q000706:statistics & numerical data*
Epidemiology; Infectious Diseases