Return to Work in Out-of-Hospital Cardiac Arrest Survivors: A Nationwide Register-Based Follow-Up Study.
BACKGROUND
Data on long-term function of out-of-hospital cardiac arrest survivors are sparse. We examined return to work as a proxy of preserved function without major neurologic deficits in survivors.


RESULTS
In Denmark, out-of-hospital cardiac arrests have been systematically reported to the Danish Cardiac Arrest Register since 2001. During 2001-2011, we identified 4354 patients employed before arrest among 12 332 working-age patients (18-65 years), of whom 796 survived to day 30. Among 796 survivors (median age, 53 years [quartile 1-3, 46-59 years]; 81.5% men), 610 (76.6%) returned to work in a median time of 4 months [quartile 1-3, 1-19 months], with a median time of 3 years spent back at work. A total of 74.6% (N=455) remained employed without using sick leave during the first 6 months after returning to work. This latter proportion of survivors returning to work increased over time (66.1% in 2001-2005 versus 78.1% in 2006-2011; P=0.002). In multivariable Cox regression analysis, factors associated with return to work with ≥6 months of sustainable employment were as follows: (1) arrest during 2006-2011 versus 2001-2005, hazard ratio (HR), 1.38 (95% CI, 1.05-1.82); (2) male sex, HR, 1.48 (95% CI, 1.06-2.07); (3) age of 18 to 49 versus 50 to 65 years, HR, 1.32 (95% CI, 1.02-1.68); (4) bystander-witnessed arrest, HR, 1.79 (95% CI, 1.17-2.76); and (5) bystander cardiopulmonary resuscitation, HR, 1.38 (95% CI, 1.02-1.87).


CONCLUSIONS
Of 30-day survivors employed before arrest, 76.6% returned to work. The percentage of survivors returning to work increased significantly, along with improved survival during 2001-2011, suggesting an increase in the proportion of survivors with preserved function over time.
From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T-P.); Prehospital Emergency Medical Services, Regions of Denmark: The Capital (F.K.L.), Zealand (O.M.H.), South Denmark (T.L.-J.), Central (E.F.C.), and North Denmark (P.A.H.); Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (L.K.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.G.); and Danish Heart Foundation, Copenhagen, Denmark (G.G.). kdks@rn.dk.
Kristian
K
Kragholm
From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T-P.); Prehospital Emergency Medical Services, Regions of Denmark: The Capital (F.K.L.), Zealand (O.M.H.), South Denmark (T.L.-J.), Central (E.F.C.), and North Denmark (P.A.H.); Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (L.K.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.G.); and Danish Heart Foundation, Copenhagen, Denmark (G.G.).
Mads
M
Wissenberg
From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T-P.); Prehospital Emergency Medical Services, Regions of Denmark: The Capital (F.K.L.), Zealand (O.M.H.), South Denmark (T.L.-J.), Central (E.F.C.), and North Denmark (P.A.H.); Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (L.K.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.G.); and Danish Heart Foundation, Copenhagen, Denmark (G.G.).
Rikke Normark
RN
Mortensen
From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T-P.); Prehospital Emergency Medical Services, Regions of Denmark: The Capital (F.K.L.), Zealand (O.M.H.), South Denmark (T.L.-J.), Central (E.F.C.), and North Denmark (P.A.H.); Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (L.K.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.G.); and Danish Heart Foundation, Copenhagen, Denmark (G.G.).
Kirsten
K
Fonager
From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T-P.); Prehospital Emergency Medical Services, Regions of Denmark: The Capital (F.K.L.), Zealand (O.M.H.), South Denmark (T.L.-J.), Central (E.F.C.), and North Denmark (P.A.H.); Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (L.K.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.G.); and Danish Heart Foundation, Copenhagen, Denmark (G.G.).
Svend Eggert
SE
Jensen
From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T-P.); Prehospital Emergency Medical Services, Regions of Denmark: The Capital (F.K.L.), Zealand (O.M.H.), South Denmark (T.L.-J.), Central (E.F.C.), and North Denmark (P.A.H.); Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (L.K.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.G.); and Danish Heart Foundation, Copenhagen, Denmark (G.G.).
Shahzleen
S
Rajan
From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T-P.); Prehospital Emergency Medical Services, Regions of Denmark: The Capital (F.K.L.), Zealand (O.M.H.), South Denmark (T.L.-J.), Central (E.F.C.), and North Denmark (P.A.H.); Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (L.K.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.G.); and Danish Heart Foundation, Copenhagen, Denmark (G.G.).
Freddy Knudsen
FK
Lippert
From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T-P.); Prehospital Emergency Medical Services, Regions of Denmark: The Capital (F.K.L.), Zealand (O.M.H.), South Denmark (T.L.-J.), Central (E.F.C.), and North Denmark (P.A.H.); Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (L.K.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.G.); and Danish Heart Foundation, Copenhagen, Denmark (G.G.).
Erika Frischknecht
EF
Christensen
From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T-P.); Prehospital Emergency Medical Services, Regions of Denmark: The Capital (F.K.L.), Zealand (O.M.H.), South Denmark (T.L.-J.), Central (E.F.C.), and North Denmark (P.A.H.); Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (L.K.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.G.); and Danish Heart Foundation, Copenhagen, Denmark (G.G.).
Poul Anders
PA
Hansen
From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T-P.); Prehospital Emergency Medical Services, Regions of Denmark: The Capital (F.K.L.), Zealand (O.M.H.), South Denmark (T.L.-J.), Central (E.F.C.), and North Denmark (P.A.H.); Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (L.K.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.G.); and Danish Heart Foundation, Copenhagen, Denmark (G.G.).
Torsten
T
Lang-Jensen
From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T-P.); Prehospital Emergency Medical Services, Regions of Denmark: The Capital (F.K.L.), Zealand (O.M.H.), South Denmark (T.L.-J.), Central (E.F.C.), and North Denmark (P.A.H.); Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (L.K.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.G.); and Danish Heart Foundation, Copenhagen, Denmark (G.G.).
Ole Mazur
OM
Hendriksen
From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T-P.); Prehospital Emergency Medical Services, Regions of Denmark: The Capital (F.K.L.), Zealand (O.M.H.), South Denmark (T.L.-J.), Central (E.F.C.), and North Denmark (P.A.H.); Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (L.K.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.G.); and Danish Heart Foundation, Copenhagen, Denmark (G.G.).
Lars
L
Kober
From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T-P.); Prehospital Emergency Medical Services, Regions of Denmark: The Capital (F.K.L.), Zealand (O.M.H.), South Denmark (T.L.-J.), Central (E.F.C.), and North Denmark (P.A.H.); Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (L.K.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.G.); and Danish Heart Foundation, Copenhagen, Denmark (G.G.).
Gunnar
G
Gislason
From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T-P.); Prehospital Emergency Medical Services, Regions of Denmark: The Capital (F.K.L.), Zealand (O.M.H.), South Denmark (T.L.-J.), Central (E.F.C.), and North Denmark (P.A.H.); Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (L.K.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.G.); and Danish Heart Foundation, Copenhagen, Denmark (G.G.).
Christian
C
Torp-Pedersen
From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T-P.); Prehospital Emergency Medical Services, Regions of Denmark: The Capital (F.K.L.), Zealand (O.M.H.), South Denmark (T.L.-J.), Central (E.F.C.), and North Denmark (P.A.H.); Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (L.K.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.G.); and Danish Heart Foundation, Copenhagen, Denmark (G.G.).
Bodil Steen
BS
Rasmussen
D000293:Adolescent; D000328:Adult; D000368:Aged; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002534:Hypoxia, Brain / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000150:complications / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012042:Registries; D062707:Return to Work; D012307:Risk Factors; D012456:Salaries and Fringe Benefits; D012959:Socioeconomic Factors; D017741:Survivors / Q000706:statistics & numerical data*; D055815:Young Adult
cardiopulmonary resuscitation; epidemiology; heart arrest