title: Reduced ability to work both before and after infectious spondylodiscitis in working-age patients.
abstract: BACKGROUND
  As little is known about the ability to work in patients with infectious spondylodiscitis, we compared the relation between the workforce before infection with that of a reference population and described the patients' ability to work after infection including predictors of return to work (RTW).
  
  
  METHODS
  We identified all patients aged 20-57 years treated for infectious spondylodiscitis January 1994-May 2009 at hospitals in Funen County, Denmark. The work status of each week from 2 years before until 2 years after index date was compared with that of a reference population. Time to RTW was described using cumulative incidence curves and univariate cause-specific Cox-regression analyses (hazard ratios - HRs).
  
  
  RESULTS
  Of 112 identified patients, 8 (7%) died within the first year and 48 (43%) were part of the workforce 1 year before index. Through the entire observation period, the patients had lower affiliation to the workforce compared with the reference population. During the observation period, the proportion of patients on permanent disability pension increased from 24% to 38% and the proportion of self-supporters decreased from 58% to 33%. Seventy-three per cent of the patients being part of the workforce 1 year before index returned to the workforce within the 2 year follow-up. Main predictor of RTW was being part of the workforce 1 year before index (HR = 7.8; CI: 2.4-25.3).
  
  
  CONCLUSIONS
  Patients with infectious spondylodiscitis were less likely to be part of the workforce before infection compared with a reference population and infection further lowered their ability to RTW.
authors.affiliation: a Department of Clinical Research , University of Southern Denmark , Odense , Denmark.|b Department of Infectious Diseases, Odense University Hospital , Odense , Denmark.
authors.forename: Michala
authors.initials: M
authors.lastname: Kehrer
authors.affiliation: c Department of Clinical Biochemistry and Pharmacology , Odense University Hospital , Odense , Denmark.
authors.forename: Jesper
authors.initials: J
authors.lastname: Hallas
authors.affiliation: d Occupational and Environmental Medicine , University of Southern Denmark , Odense , Denmark.
authors.forename: Jesper
authors.initials: J
authors.lastname: Bælum
authors.affiliation: e Department of Clinical Microbiology , Odense University Hospital , Odense , Denmark.
authors.forename: Thøger Gorm
authors.initials: TG
authors.lastname: Jensen
authors.affiliation: b Department of Infectious Diseases, Odense University Hospital , Odense , Denmark.
authors.forename: Court
authors.initials: C
authors.lastname: Pedersen
authors.affiliation: a Department of Clinical Research , University of Southern Denmark , Odense , Denmark.|f Department of Emergency Medicine , Odense University Hospital , Odense , Denmark.
authors.forename: Annmarie Touborg
authors.initials: AT
authors.lastname: Lassen
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D006233:Persons with Disabilities; D015299:Discitis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062707:Return to Work; D055815:Young Adult
keywords: Vertebral osteomyelitis; bone infection; prognosis; return to work; workforce