Diagnosis-specific sickness absence as a predictor of mortality: the Whitehall II prospective cohort study.
Diagnosis-specific sickness absence as a predictor of mortality: the Whitehall II prospective cohort study.
复制标题
诊断特定的疾病缺乏作为死亡率的预测指标：Whitehall II前瞻性队列研究。
DOI：
10.1136/bmj.a1469
复制
发表时间：
2008-10-02
期刊：
影响因子：
--
通讯作者：
Whitehall II prospective cohort study
中科院分区：
文献类型：
--
作者：
Head J;Ferrie JE;Alexanderson K;Westerlund H;Vahtera J;Kivimäki M;Whitehall II prospective cohort study
目的探讨了解病假诊断是否能提高死亡率的预测。设计1985-2008年建立的前瞻性队列研究。病假记录，包括诊断，是从计算机化的登记表中获得的。在伦敦设立了20个公务员部门。参与者：年龄在35-55岁的6478名公务员。主要观察指标为2004年以前的所有死因、心血管疾病和癌症死亡率，平均随访13年。结果在调整了年龄、性别和就业级别后，在三年期间有一次或多次经医学证明的病假(>；7天)的员工的死亡率是没有经医学证明的病假的1.7倍(95%可信区间1.3至2.1)。纳入诊断改善了全因死亡率的预测(P=0.03)。因循环系统疾病而缺席的死亡风险比为4.7(2.6~8.5)，外科手术为2.2(1.4~3.3)，精神病诊断为1.9(1.2~3.1)。精神缺勤也预示着癌症死亡率(2.5(1.3至4.7))。感染、呼吸和损伤缺勤与总死亡率的相关性不那么显著(风险比从1.5到1.7)，肌肉骨骼缺勤和死亡率之间没有关联。结论：除肌肉骨骼疾病外，经医学证实的缺席的主要诊断与死亡率的增加有关。关于疾病缺勤诊断的数据可以提供有用的信息，以确定健康风险增加的群体和需要有针对性的干预措施。
Objective To investigate whether knowing the diagnosis for sickness absence improves prediction of mortality. Design Prospective cohort study established in 1985-8. Sickness absence records including diagnoses were obtained from computerised registers. Setting 20 civil service departments in London. Participants 6478 civil servants aged 35-55 years. Main outcome measures All cause, cardiovascular, and cancer mortality until 2004, average follow-up 13 years. Results After adjustment for age, sex, and employment grade, employees who had one or more medically certified spells of sickness absence (>7 days) in a three year period had a mortality 1.7 (95% CI 1.3 to 2.1) times greater than those with no medically certified spells. Inclusion of diagnoses improved the prediction of all cause mortality (P=0.03). The hazard ratio for mortality was 4.7 (2.6 to 8.5) for absences with circulatory disease diagnoses, 2.2 (1.4 to 3.3) for surgical operations, and 1.9 (1.2 to 3.1) for psychiatric diagnoses. Psychiatric absences were also predictive of cancer mortality (2.5 (1.3 to 4.7)). Associations of infectious, respiratory, and injury absences with overall mortality were less marked (hazard ratios from 1.5 to 1.7), and there was no association between musculoskeletal absences and mortality. Conclusions Major diagnoses for medically certified absences were associated with increased mortality, with the exception of musculoskeletal disease. Data on sickness absence diagnoses may provide useful information to identify groups with increased health risk and a need for targeted interventions.
登录
查看更多内容
影响因子：
7.4
作者：
Falagas, Matthew E.;Zarkadoulia, Effie A.;Ioannidou, Eleni N.;Peppas, George;Christodoulou, Christos;Rafailidis, Petros I.
通讯作者：
Rafailidis, Petros I.
影响因子：
5
作者：
EAKER, ED;PINSKY, J;CASTELLI, WP
通讯作者：
CASTELLI, WP
影响因子：
4.9
作者：
Feeney, A;North, F;Marmot, M
通讯作者：
Marmot, M
影响因子：
168.9
作者：
MARMOT, MG;SMITH, GD;FEENEY, A
通讯作者：
FEENEY, A
影响因子：
3.1
作者：
Goodwin, Renee D.;Cox, Brian J.;Clara, Ian
通讯作者：
Clara, Ian