Risk of disability pension for patients diagnosed with haematological malignancies: A register-based cohort study
Risk of disability pension for patients diagnosed with haematological malignancies: A register-based cohort study
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DOI：
10.3109/0284186x.2013.875625
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发表时间：
2014-06-01
期刊：
影响因子：
3.1
通讯作者：
de Thurah, Annette
中科院分区：
文献类型：
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作者：
Horsboel, Trine A.;Nielsen, Claus V.;de Thurah, Annette
血液系统恶性肿瘤患者遇到与工作有关的问题的风险增加。本研究的目的是比较被诊断为八种血液病亚型的患者与参考队列的残疾养老金风险，并确定这些亚型之间的相对风险是否不同；评估社会经济因素、人口统计因素和临床因素对残疾养老金风险的影响；并调查这些关联在参考队列和患者队列中是否不同。我们结合了2000至2007年间丹麦国家登记的被诊断为血液系统恶性肿瘤的患者的数据，以及一个没有这些疾病病史的参考队列。共对3194名患者和28627名参照者进行了跟踪调查，直到DP、移民、老年养老金或预期养老金、死亡或2012年2月26日(以先到者为准)。共有550名患者(17%)和1511名参照者(5%)获得DP。年龄和性别调整后的相对危险度在血液系统恶性肿瘤亚组之间有显著差异，范围从霍奇金淋巴瘤患者的2.64(95%可信区间1.84~3.78)到多发性骨髓瘤患者的12.53(95%可信区间10.57~14.85)。在患者队列中，我们发现性别、年龄、合并症、种族、教育水平、家庭收入、长期病假病史以及确诊后是否需要使用抗焦虑药物或抗抑郁药物与接受DP相关。然而，在参考队列中，这些关联性大多更强。与参考队列相比，所有8种血液恶性肿瘤亚型均与DP风险增加相关。不同亚型的相对风险不同，多发性骨髓瘤患者发生DP的风险最高。此外，在参考队列中，大多数社会经济、人口和临床因素对DP风险的影响比在患者队列中更大。
Patients with haematological malignancies are at increased risk of experiencing work-related problems. The aims of this study were to compare the risk of disability pension (DP) among patients diagnosed with eight subtypes of haematological malignancies to a reference cohort, and to determine if relative risks differ between these subtypes; to evaluate the influence of socioeconomic factors, demographic factors, and clinical factors on the risk of DP; and to investigate if these associations differ between the reference cohort and the patient cohort.Material and methods. We combined data from national registers on Danish patients diagnosed with haematological malignancies between 2000 and 2007 and a reference cohort without a history of these diseases. A total of 3194 patients and 28 627 reference individuals were followed until DP, emigration, old age pension or anticipatory pension, death or 26 February 2012, whichever came first.Results. A total of 550 (17%) patients and 1511 (5%) reference individuals were granted DP. Age-and gender-adjusted relative risks differed significantly between the subgroups of haematological malignancies and ranged from 2.64 (95% CI 1.84-3.78) for patients with Hodgkin lymphoma to 12.53 (95% CI 10.57-14.85) for patients with multiple myeloma. In the patient cohort we found that gender, age, comorbidity, ethnicity, educational level, household income, history of long-term sick leave, and need of treatment with anxiolytics or antidepressants after diagnosis were associated with receiving DP. However, most of these associations were stronger in the reference cohort.Conclusion. All eight subtypes of haematological malignancies were associated with an increased risk of DP compared to the reference cohort. The relative risks differed according to subtype, and patients with multiple myeloma had the highest risk of DP. Furthermore, most socioeconomic, demographic and clinical factors had a stronger impact on the risk of DP in the reference cohort than in the patient cohort.