Impact of Health Care System Delay in Patients With ST-Elevation Myocardial Infarction on Return to Labor Market and Work Retirement

Kristina Grønborg Laut; Jacob Hjort; Thomas Engstrøm; Lisette Okkels Jensen; Hans-Henrik Tilsted Hansen; Jan Skov Jensen; Frants Pedersen; Erik Jørgensen; Lene Holmvang; Alma Becic Pedersen; Erika Frischknecht Christensen; Freddy Lippert; Torsten Lang-Jensen; Henning Jans; Poul Anders Hansen; Sven Trautner; Steen Dalby Kristensen; Jens Flensted Lassen; Timothy L Lash; Peter Clemmensen; Christian Juhl Terkelsen

doi:10.1016/j.amjcard.2014.09.018

Impact of Health Care System Delay in Patients With ST-Elevation Myocardial Infarction on Return to Labor Market and Work Retirement

Kristina Grønborg Laut, Jacob Hjort, Thomas Engstrøm, Lisette Okkels Jensen, Hans-Henrik Tilsted Hansen, Jan Skov Jensen, Frants Pedersen, Erik Jørgensen, Lene Holmvang, Alma Becic Pedersen, Erika Frischknecht Christensen, Freddy Lippert, Torsten Lang-Jensen, Henning Jans, Poul Anders Hansen, Sven Trautner, Steen Dalby Kristensen, Jens Flensted Lassen, Timothy L Lash, Peter ClemmensenChristian Juhl Terkelsen

Department of Clinical Medicine

13 Citations (Scopus)

Abstract

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.

Original language	English
Journal	American Journal of Cardiology
Volume	114
Issue number	12
Pages (from-to)	1810–1816
Number of pages	7
ISSN	0002-9149
DOIs	https://doi.org/10.1016/j.amjcard.2014.09.018
Publication status	Published - 15 Dec 2014

Keywords

Delivery of Health Care
Electrocardiography
Emergency Medical Services
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction
Myocardial Revascularization
Prognosis
Registries
Retirement
Retrospective Studies
Return to Work
Time Factors

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10.1016/j.amjcard.2014.09.018

http://www.ajconline.org/article/S0002914914018463/pdf

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Laut, K. G., Hjort, J., Engstrøm, T., Jensen, L. O., Tilsted Hansen, H-H., Jensen, J. S., Pedersen, F., Jørgensen, E., Holmvang, L., Pedersen, A. B., Christensen, E. F., Lippert, F., Lang-Jensen, T., Jans, H., Hansen, P. A., Trautner, S., Kristensen, S. D., Lassen, J. F., Lash, T. L., ... Terkelsen, C. J. (2014). Impact of Health Care System Delay in Patients With ST-Elevation Myocardial Infarction on Return to Labor Market and Work Retirement. American Journal of Cardiology, 114(12), 1810–1816. https://doi.org/10.1016/j.amjcard.2014.09.018

Impact of Health Care System Delay in Patients With ST-Elevation Myocardial Infarction on Return to Labor Market and Work Retirement. / Laut, Kristina Grønborg; Hjort, Jacob; Engstrøm, Thomas et al.

In: American Journal of Cardiology, Vol. 114, No. 12, 15.12.2014, p. 1810–1816.

Research output: Contribution to journal › Journal article › Research › peer-review

Laut, KG, Hjort, J, Engstrøm, T, Jensen, LO, Tilsted Hansen, H-H, Jensen, JS, Pedersen, F, Jørgensen, E, Holmvang, L, Pedersen, AB, Christensen, EF, Lippert, F, Lang-Jensen, T, Jans, H, Hansen, PA, Trautner, S, Kristensen, SD, Lassen, JF, Lash, TL, Clemmensen, P & Terkelsen, CJ 2014, 'Impact of Health Care System Delay in Patients With ST-Elevation Myocardial Infarction on Return to Labor Market and Work Retirement', American Journal of Cardiology, vol. 114, no. 12, pp. 1810–1816. https://doi.org/10.1016/j.amjcard.2014.09.018

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title = "Impact of Health Care System Delay in Patients With ST-Elevation Myocardial Infarction on Return to Labor Market and Work Retirement",

abstract = "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.",

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AU - Laut, Kristina Grønborg

AU - Hjort, Jacob

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

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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.

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KW - Electrocardiography

KW - Emergency Medical Services

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Middle Aged

KW - Myocardial Infarction

KW - Myocardial Revascularization

KW - Prognosis

KW - Registries

KW - Retirement

KW - Retrospective Studies

KW - Return to Work

KW - Time Factors

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JO - Am. J. Cardiol.

JF - Am. J. Cardiol.

IS - 12

ER -

Impact of Health Care System Delay in Patients With ST-Elevation Myocardial Infarction on Return to Labor Market and Work Retirement

Abstract

Keywords

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