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Kragholm K, Wissenberg M, Mortensen RN, Fonager K, Jensen SE, Rajan S, Lippert FK, Christensen EF, Hansen PA, Lang-Jensen T, Hendriksen OM, Kober L, Gislason G, Torp-Pedersen C, Rasmussen BS. Return to Work in Out-of-Hospital Cardiac Arrest Survivors. Circulation 2015; 131:1682-90. [DOI: 10.1161/circulationaha.114.011366] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 03/05/2015] [Indexed: 11/16/2022]
Abstract
Background—
Data on long-term function of out-of-hospital cardiac arrest survivors are sparse. We examined return to work as a proxy of preserved function without major neurologic deficits in survivors.
Methods and Results—
In Denmark, out-of-hospital cardiac arrests have been systematically reported to the Danish Cardiac Arrest Register since 2001. During 2001–2011, we identified 4354 patients employed before arrest among 12 332 working-age patients (18–65 years), of whom 796 survived to day 30. Among 796 survivors (median age, 53 years [quartile 1–3, 46–59 years]; 81.5% men), 610 (76.6%) returned to work in a median time of 4 months [quartile 1–3, 1–19 months], with a median time of 3 years spent back at work. A total of 74.6% (N=455) remained employed without using sick leave during the first 6 months after returning to work. This latter proportion of survivors returning to work increased over time (66.1% in 2001–2005 versus 78.1% in 2006–2011;
P
=0.002). In multivariable Cox regression analysis, factors associated with return to work with ≥6 months of sustainable employment were as follows: (1) arrest during 2006–2011 versus 2001–2005, hazard ratio (HR), 1.38 (95% CI, 1.05–1.82); (2) male sex, HR, 1.48 (95% CI, 1.06–2.07); (3) age of 18 to 49 versus 50 to 65 years, HR, 1.32 (95% CI, 1.02–1.68); (4) bystander-witnessed arrest, HR, 1.79 (95% CI, 1.17–2.76); and (5) bystander cardiopulmonary resuscitation, HR, 1.38 (95% CI, 1.02–1.87).
Conclusions—
Of 30-day survivors employed before arrest, 76.6% returned to work. The percentage of survivors returning to work increased significantly, along with improved survival during 2001–2011, suggesting an increase in the proportion of survivors with preserved function over time.
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Affiliation(s)
- Kristian Kragholm
- From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T
| | - Mads Wissenberg
- From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T
| | - Rikke Normark Mortensen
- From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T
| | - Kirsten Fonager
- From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T
| | - Svend Eggert Jensen
- From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T
| | - Shahzleen Rajan
- From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T
| | - Freddy Knudsen Lippert
- From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T
| | - Erika Frischknecht Christensen
- From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T
| | - Poul Anders Hansen
- From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T
| | - Torsten Lang-Jensen
- From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T
| | - Ole Mazur Hendriksen
- From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T
| | - Lars Kober
- From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T
| | - Gunnar Gislason
- From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T
| | - Christian Torp-Pedersen
- From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T
| | - Bodil Steen Rasmussen
- From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T
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