Employment status at time of first hospitalization for heart failure is associated with a higher risk of death and rehospitalization for heart failure

TY - JOUR

T1 - Employment status at time of first hospitalization for heart failure is associated with a higher risk of death and rehospitalization for heart failure

AU - Rørth, Rasmus

AU - Fosbøl, Emil L.

AU - Mogensen, Ulrik M.

AU - Kragholm, Kristian

AU - Numé, Anna Karin

AU - Gislason, Gunnar H.

AU - Jhund, Pardeep S.

AU - Petrie, Mark C.

AU - McMurray, John J.V.

AU - Torp-Pedersen, Christian

AU - Køber, Lars

AU - Kristensen, Søren L.

PY - 2018/2

Y1 - 2018/2

N2 - Aims: Employment status at time of first heart failure (HF) hospitalization may be an indicator of both self-perceived and objective health status. In this study, we examined the association between employment status and the risk of all-cause mortality and recurrent HF hospitalization in a nationwide cohort of patients with HF. Methods and results: We identified all patients of working age (18–60 years) with a first HF hospitalization in the period 1997–2015 in Denmark, categorized according to whether or not they were part of the workforce at time of the index admission. The primary outcome was death from any cause and the secondary outcome was readmission for HF. Cumulative incidence curves, binomial regression and Cox regression models were used to assess outcomes. Of 25 571 patients with a first hospitalization for HF, 15 428 (60%) were part of the workforce at baseline. Patients in the workforce were significantly younger (53 vs. 55 years) more likely to be male (75% vs 64%) and less likely to have diabetes (13% vs 22%) and chronic obstructive pulmonary disease (5% vs 10%) (all P < 0.0001). Not being part of the workforce was associated with a significantly higher risk of death [hazard ratio (HR) 1.59; 95% confidence interval (CI) 1.50–1.68] and rehospitalization for HF (HR 1.09; 95% CI 1.05–1.14), in analyses adjusted for age, sex, co-morbidities, education level, calendar time, and duration of first HF hospitalization. Conclusion: Not being part of the workforce at time of first HF hospitalization was independently associated with increased mortality and recurrent HF hospitalization.

AB - Aims: Employment status at time of first heart failure (HF) hospitalization may be an indicator of both self-perceived and objective health status. In this study, we examined the association between employment status and the risk of all-cause mortality and recurrent HF hospitalization in a nationwide cohort of patients with HF. Methods and results: We identified all patients of working age (18–60 years) with a first HF hospitalization in the period 1997–2015 in Denmark, categorized according to whether or not they were part of the workforce at time of the index admission. The primary outcome was death from any cause and the secondary outcome was readmission for HF. Cumulative incidence curves, binomial regression and Cox regression models were used to assess outcomes. Of 25 571 patients with a first hospitalization for HF, 15 428 (60%) were part of the workforce at baseline. Patients in the workforce were significantly younger (53 vs. 55 years) more likely to be male (75% vs 64%) and less likely to have diabetes (13% vs 22%) and chronic obstructive pulmonary disease (5% vs 10%) (all P < 0.0001). Not being part of the workforce was associated with a significantly higher risk of death [hazard ratio (HR) 1.59; 95% confidence interval (CI) 1.50–1.68] and rehospitalization for HF (HR 1.09; 95% CI 1.05–1.14), in analyses adjusted for age, sex, co-morbidities, education level, calendar time, and duration of first HF hospitalization. Conclusion: Not being part of the workforce at time of first HF hospitalization was independently associated with increased mortality and recurrent HF hospitalization.

KW - Employment status

KW - Epidemiology

KW - Heart failure

U2 - 10.1002/ejhf.1046

DO - 10.1002/ejhf.1046

M3 - Journal article

C2 - 29148231

AN - SCOPUS:85034212846

SN - 1388-9842

VL - 20

SP - 240

EP - 247

JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

IS - 2

ER -