title: Factors influencing return-to-work after cerebrovascular disease: the importance of previous cardiovascular risk.
abstract: BACKGROUND
  The role of prior cardiovascular risk (CVR) in the multifactorial process of returning to work after a cerebrovascular event has not been adequately investigated. Therefore, the objective of the present study was to analyse the association between previous CVR level, cardiovascular risk factors (CVRFs) and return-to-work (RTW) following cerebrovascular disease.
  
  
  METHODS
  This was a prospective observational study.
  
  
  METHODS
  We analysed a cohort of 348 patients who had experienced an episode of cerebrovascular disease-related work absence. These individuals were selected from the ICARIA study (Ibermutuamur CArdiovascular RIsk Assessment). Global CVR was assessed using the SCORE system. We investigated the association between demographics, work-related variables, CVRFs and RTW following a cerebrovascular event.
  
  
  RESULTS
  We found that a total of 254 individuals (73.0%; 95% CI: 68.3-77.7) returned to work after cerebrovascular disease. Also, we observed a median loss of 12 working years due to disability. Moreover, adjusting for potential confounders revealed that low CVR level and the absence of the following CVRFs was associated with a higher likelihood of RTW: low vs moderate-to-high CVR level (OR: 2.55; 95% CI: 1.42-4.57), no hypertension before stroke (OR: 1.95; 95% CI: 1.11-3.41), non-smoker status (OR: 2.26; 95% CI: 1.30-3.93) and no previous diabetes (OR: 2.46; 95% CI: 1.26-4.79).
  
  
  CONCLUSIONS
  Low CVR, along with the absence of several CVRFs, can be used to predict RTW rates following cerebrovascular events. Therefore, controlling hypertension, tobacco consumption and diabetes might contribute to the effectiveness of multidisciplinary rehabilitation and/or secondary/tertiary prevention programs for cerebrovascular disease.
authors: Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Madrid, Spain carloscatalina@ibermutuamur.es.
authors: Carlos
authors: C
authors: Catalina-Romero
authors: Hypertension Unit, Department of Nephrology, Hospital 12 de Octubre, Madrid, Spain.
authors: Luis Miguel
authors: LM
authors: Ruilope
authors: Department of Internal Medicine. University Hospital "Virgen de la Victoria", and University of Malaga, Malaga, Spain.
authors: Miguel Angel
authors: MA
authors: Sánchez-Chaparro
authors: Department of Internal Medicine. University Hospital "Virgen de la Victoria", and University of Malaga, Malaga, Spain.
authors: Pedro
authors: P
authors: Valdivielso
authors: Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Madrid, Spain.
authors: Martha
authors: M
authors: Cabrera-Sierra
authors: Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Madrid, Spain.
authors: Carlos
authors: C
authors: Fernández-Labandera
authors: Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Madrid, Spain.
authors: Montserrat
authors: M
authors: Ruiz-Moraga
authors: Department of Internal Medicine, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain.
authors: Arturo
authors: A
authors: Gonzalez-Quintela
authors: Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Madrid, Spain.
authors: Eva
authors: E
authors: Calvo-Bonacho
mesh_terms: D000328:Adult; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D062707:Return to Work; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D000074606:Smoking Prevention; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D014938:Work Capacity Evaluation
keywords: Cardiovascular diseases; cerebrovascular disorders; return to work; risk factors; stroke