title: Return to the Workforce After First Hospitalization for Heart Failure: A Danish Nationwide Cohort Study.
abstract: BACKGROUND
  Return to work is important financially, as a marker of functional status and for self-esteem in patients developing chronic illness. We examined return to work after first heart failure (HF) hospitalization.
  
  
  METHODS
  By individual-level linkage of nationwide Danish registries, we identified 21 455 patients of working age (18-60 years) with a first HF hospitalization in the period from 1997 to 2012. Of these patients, 11 880 (55%) were in the workforce before HF hospitalization and comprised the study population. We applied logistic regression to estimate odds ratios for associations between age, sex, length of hospital stay, level of education, income, comorbidity, and return to work.
  
  
  RESULTS
  One year after first HF hospitalization, 8040 (67.7%) returned to the workforce, 2981 (25.1%) did not, 805 (6.7%) died, and 54 (0.5%) emigrated. Predictors of return to work included younger age (18-30 versus 51-60 years; odds ratio [OR], 3.12; 95% confidence interval [CI], 2.42-4.03), male sex (OR, 1.22; 95% CI, 1.12-1.34), and level of education (long-higher versus basic school; OR, 2.06; 95% CI, 1.63-2.60). Conversely, hospital stay >7 days (OR, 0.56; 95% CI, 0.51-0.62) and comorbidity including history of stroke (OR, 0.55; 95% CI, 0.45-0.69), chronic kidney disease (OR, 0.46; 95% CI, 0.36-0.59), chronic obstructive pulmonary disease (OR, 0.62; 95% CI, 0.52-0.75), diabetes mellitus (OR 0.76; 95% CI, 0.68-0.85), and cancer (OR, 0.49; 95% CI, 0.40-0.61) were all significantly associated with lower chance of return to work.
  
  
  CONCLUSIONS
  Patients in the workforce before HF hospitalization had low mortality but high risk of detachment from the workforce 1 year later. Young age, male sex, and a higher level of education were predictors of return to work.
authors: From Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark (R.R., E.L.F., U.M.M., L.K., S.L.K.); BHF Cardiovascular Research Centre, University of Glasgow, UK (C.W., U.M.M., M.C.P., P.S.J., J.J.V.M., S.L.K.); Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Centre, Aalborg University Hospital, Denmark (K.K.); Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark (M.L., G.H.G.); Department of Public health, Section of Biostatistics, University of Copenhagen, Denmark (T.A.G.); and Department of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.). rasmusroerth@hotmail.com.
authors: Rasmus
authors: R
authors: Rørth
authors: From Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark (R.R., E.L.F., U.M.M., L.K., S.L.K.); BHF Cardiovascular Research Centre, University of Glasgow, UK (C.W., U.M.M., M.C.P., P.S.J., J.J.V.M., S.L.K.); Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Centre, Aalborg University Hospital, Denmark (K.K.); Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark (M.L., G.H.G.); Department of Public health, Section of Biostatistics, University of Copenhagen, Denmark (T.A.G.); and Department of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors: Chih
authors: C
authors: Wong
authors: From Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark (R.R., E.L.F., U.M.M., L.K., S.L.K.); BHF Cardiovascular Research Centre, University of Glasgow, UK (C.W., U.M.M., M.C.P., P.S.J., J.J.V.M., S.L.K.); Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Centre, Aalborg University Hospital, Denmark (K.K.); Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark (M.L., G.H.G.); Department of Public health, Section of Biostatistics, University of Copenhagen, Denmark (T.A.G.); and Department of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors: Kristian
authors: K
authors: Kragholm
authors: From Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark (R.R., E.L.F., U.M.M., L.K., S.L.K.); BHF Cardiovascular Research Centre, University of Glasgow, UK (C.W., U.M.M., M.C.P., P.S.J., J.J.V.M., S.L.K.); Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Centre, Aalborg University Hospital, Denmark (K.K.); Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark (M.L., G.H.G.); Department of Public health, Section of Biostatistics, University of Copenhagen, Denmark (T.A.G.); and Department of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors: Emil L
authors: EL
authors: Fosbøl
authors: From Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark (R.R., E.L.F., U.M.M., L.K., S.L.K.); BHF Cardiovascular Research Centre, University of Glasgow, UK (C.W., U.M.M., M.C.P., P.S.J., J.J.V.M., S.L.K.); Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Centre, Aalborg University Hospital, Denmark (K.K.); Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark (M.L., G.H.G.); Department of Public health, Section of Biostatistics, University of Copenhagen, Denmark (T.A.G.); and Department of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors: Ulrik M
authors: UM
authors: Mogensen
authors: From Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark (R.R., E.L.F., U.M.M., L.K., S.L.K.); BHF Cardiovascular Research Centre, University of Glasgow, UK (C.W., U.M.M., M.C.P., P.S.J., J.J.V.M., S.L.K.); Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Centre, Aalborg University Hospital, Denmark (K.K.); Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark (M.L., G.H.G.); Department of Public health, Section of Biostatistics, University of Copenhagen, Denmark (T.A.G.); and Department of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors: Morten
authors: M
authors: Lamberts
authors: From Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark (R.R., E.L.F., U.M.M., L.K., S.L.K.); BHF Cardiovascular Research Centre, University of Glasgow, UK (C.W., U.M.M., M.C.P., P.S.J., J.J.V.M., S.L.K.); Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Centre, Aalborg University Hospital, Denmark (K.K.); Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark (M.L., G.H.G.); Department of Public health, Section of Biostatistics, University of Copenhagen, Denmark (T.A.G.); and Department of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors: Mark C
authors: MC
authors: Petrie
authors: From Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark (R.R., E.L.F., U.M.M., L.K., S.L.K.); BHF Cardiovascular Research Centre, University of Glasgow, UK (C.W., U.M.M., M.C.P., P.S.J., J.J.V.M., S.L.K.); Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Centre, Aalborg University Hospital, Denmark (K.K.); Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark (M.L., G.H.G.); Department of Public health, Section of Biostatistics, University of Copenhagen, Denmark (T.A.G.); and Department of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors: Pardeep S
authors: PS
authors: Jhund
authors: From Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark (R.R., E.L.F., U.M.M., L.K., S.L.K.); BHF Cardiovascular Research Centre, University of Glasgow, UK (C.W., U.M.M., M.C.P., P.S.J., J.J.V.M., S.L.K.); Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Centre, Aalborg University Hospital, Denmark (K.K.); Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark (M.L., G.H.G.); Department of Public health, Section of Biostatistics, University of Copenhagen, Denmark (T.A.G.); and Department of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors: Thomas A
authors: TA
authors: Gerds
authors: From Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark (R.R., E.L.F., U.M.M., L.K., S.L.K.); BHF Cardiovascular Research Centre, University of Glasgow, UK (C.W., U.M.M., M.C.P., P.S.J., J.J.V.M., S.L.K.); Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Centre, Aalborg University Hospital, Denmark (K.K.); Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark (M.L., G.H.G.); Department of Public health, Section of Biostatistics, University of Copenhagen, Denmark (T.A.G.); and Department of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors: Christian
authors: C
authors: Torp-Pedersen
authors: From Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark (R.R., E.L.F., U.M.M., L.K., S.L.K.); BHF Cardiovascular Research Centre, University of Glasgow, UK (C.W., U.M.M., M.C.P., P.S.J., J.J.V.M., S.L.K.); Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Centre, Aalborg University Hospital, Denmark (K.K.); Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark (M.L., G.H.G.); Department of Public health, Section of Biostatistics, University of Copenhagen, Denmark (T.A.G.); and Department of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors: Gunnar H
authors: GH
authors: Gislason
authors: From Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark (R.R., E.L.F., U.M.M., L.K., S.L.K.); BHF Cardiovascular Research Centre, University of Glasgow, UK (C.W., U.M.M., M.C.P., P.S.J., J.J.V.M., S.L.K.); Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Centre, Aalborg University Hospital, Denmark (K.K.); Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark (M.L., G.H.G.); Department of Public health, Section of Biostatistics, University of Copenhagen, Denmark (T.A.G.); and Department of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors: John J V
authors: JJ
authors: McMurray
authors: From Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark (R.R., E.L.F., U.M.M., L.K., S.L.K.); BHF Cardiovascular Research Centre, University of Glasgow, UK (C.W., U.M.M., M.C.P., P.S.J., J.J.V.M., S.L.K.); Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Centre, Aalborg University Hospital, Denmark (K.K.); Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark (M.L., G.H.G.); Department of Public health, Section of Biostatistics, University of Copenhagen, Denmark (T.A.G.); and Department of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors: Lars
authors: L
authors: Køber
authors: From Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark (R.R., E.L.F., U.M.M., L.K., S.L.K.); BHF Cardiovascular Research Centre, University of Glasgow, UK (C.W., U.M.M., M.C.P., P.S.J., J.J.V.M., S.L.K.); Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Centre, Aalborg University Hospital, Denmark (K.K.); Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark (M.L., G.H.G.); Department of Public health, Section of Biostatistics, University of Copenhagen, Denmark (T.A.G.); and Department of Health, Science and Technology, Aalborg University, Denmark (C.T.-P.).
authors: Søren L
authors: SL
authors: Kristensen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
keywords: employment; epidemiology; heart failure; prognosis; quality of life