TY - JOUR
T1 - Impact of Health Care System Delay in Patients With ST-Elevation Myocardial Infarction on Return to Labor Market and Work Retirement
AU - Laut, Kristina Grønborg
AU - Hjort, Jakob
AU - Engstrøm, Thomas
AU - Jensen, Lisette Okkels
AU - Tilsted Hansen, Hans-Henrik
AU - Jensen, Jan Skov
AU - Pedersen, Frants
AU - Jørgensen, Erik
AU - Holmvang, Lene
AU - Pedersen, Alma Becic
AU - Christensen, Erika Frischknecht
AU - Lippert, Freddy
AU - Lang-Jensen, Torsten
AU - Jans, Henning
AU - Hansen, Poul Anders
AU - Trautner, Sven
AU - Kristensen, Steen Dalby
AU - Lassen, Jens Flensted
AU - Lash, Timothy L
AU - Clemmensen, Peter
AU - Terkelsen, Christian Juhl
N1 - Copyright © 2014 Elsevier Inc. All rights reserved.
PY - 2014/9/28
Y1 - 2014/9/28
N2 - System delay (delay from emergency medical service call to reperfusion with primary percutaneous coronary intervention [PPCI]) is acknowledged as a performance measure in ST-elevation myocardial infarction (STEMI), as shorter system delay is associated with lower mortality. It is unknown whether system delay also impacts ability to stay in the labor market. Therefore, the aim of the study was to evaluate whether system delay is associated with duration of absence from work or time to retirement from work among patients with STEMI treated with PPCI. We conducted a population-based cohort study including patients ≤67 years of age who were admitted with STEMI from January 1, 1999, to December 1, 2011 and treated with PPCI. Data were derived from Danish population-based registries. Only patients who were full- or part-time employed before their STEMI admission were included. Association between system delay and time to return to the labor market was analyzed using a competing-risk regression analysis. Association between system delay and time to retirement from work was analyzed using a Cox regression model. A total of 4,061 patients were included. Ninety-three percent returned to the labor market during 4 years of follow-up, and 41% retired during 8 years of follow-up. After adjustment, system delay >120 minutes was associated with reduced resumption of work (subhazard ratio 0.86, 95% confidence interval 0.81 to 0.92) and earlier retirement from work (hazard ratio 1.21, 95% confidence interval 1.08 to 1.36). In conclusion, system delay was associated with reduced work resumption and earlier retirement. This highlights the value of system delay as a performance measure in treating patients with STEMI.
AB - System delay (delay from emergency medical service call to reperfusion with primary percutaneous coronary intervention [PPCI]) is acknowledged as a performance measure in ST-elevation myocardial infarction (STEMI), as shorter system delay is associated with lower mortality. It is unknown whether system delay also impacts ability to stay in the labor market. Therefore, the aim of the study was to evaluate whether system delay is associated with duration of absence from work or time to retirement from work among patients with STEMI treated with PPCI. We conducted a population-based cohort study including patients ≤67 years of age who were admitted with STEMI from January 1, 1999, to December 1, 2011 and treated with PPCI. Data were derived from Danish population-based registries. Only patients who were full- or part-time employed before their STEMI admission were included. Association between system delay and time to return to the labor market was analyzed using a competing-risk regression analysis. Association between system delay and time to retirement from work was analyzed using a Cox regression model. A total of 4,061 patients were included. Ninety-three percent returned to the labor market during 4 years of follow-up, and 41% retired during 8 years of follow-up. After adjustment, system delay >120 minutes was associated with reduced resumption of work (subhazard ratio 0.86, 95% confidence interval 0.81 to 0.92) and earlier retirement from work (hazard ratio 1.21, 95% confidence interval 1.08 to 1.36). In conclusion, system delay was associated with reduced work resumption and earlier retirement. This highlights the value of system delay as a performance measure in treating patients with STEMI.
U2 - 10.1016/j.amjcard.2014.09.018
DO - 10.1016/j.amjcard.2014.09.018
M3 - Journal article
C2 - 25438906
SN - 0002-9149
VL - 114
SP - 1810
EP - 1816
JO - The American Journal of Cardiology
JF - The American Journal of Cardiology
IS - 12
ER -