Venous thromboembolism and subsequent permanent work-related disability.
Essentials The burden of venous thromboembolism (VTE) related to permanent work-related disability is unknown. In a cohort of 66 005 individuals, the risk of work-related disability after a VTE was assessed. Unprovoked VTE was associated with 52% increased risk of work-related disability. This suggests that indirect costs due to loss of work time may add to the economic burden of VTE.


SUMMARY
Background The burden of venous thromboembolism (VTE) related to permanent work-related disability has never been assessed among a general population. Therefore, we aimed to estimate the risk of work-related disability in subjects with incident VTE compared with those without VTE in a population-based cohort. Methods From the Tromsø Study and the Nord-Trøndelag Health Study (HUNT), Norway, 66 005 individuals aged 20-65 years were enrolled in 1994-1997 and followed to 31 December 2008. Incident VTE events among the study participants were identified and validated, and information on work-related disability was obtained from the Norwegian National Insurance Administration database. Cox-regression models using age as time-scale and VTE as time-varying exposure were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) adjusted for sex, body mass index, smoking, education level, marital status, history of cancer, diabetes, cardiovascular disease and self-rated general health. Results During follow-up, 384 subjects had a first VTE and 9862 participants were granted disability pension. The crude incidence rate of work-related disability after VTE was 37.5 (95% CI, 29.7-47.3) per 1000 person-years, vs. 13.5 (13.2-13.7) per 1000 person-years among those without VTE. Subjects with unprovoked VTE had a 52% higher risk of work-related disability than those without VTE (HR, 1.52; 95% CI, 1.09-2.14) after multivariable adjustment, and the association appeared to be driven by deep vein thrombosis. Conclusion VTE was associated with subsequent work-related disability in a cohort recruited from the general working-age population. Our findings suggest that indirect costs because of loss of work time may add to the economic burden of VTE.
['Braekkan|S K|SK|', 'Grosse|S D|SD|', 'Okoroh|E M|EM|', 'Tsai|J|J|', 'Cannegieter|S C|SC|', 'Naess|I A|IA|', 'Krokstad|S|S|', 'Hansen|J-B|JB|', 'Skjeldestad|F E|FE|']
D000328:Adult D000368:Aged D015992:Body Mass Index D002318:Cardiovascular Diseases D015331:Cohort Studies D006233:Disabled Persons D005260:Female D017048:Health Care Costs D006801:Humans D015994:Incidence D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D009664:Norway D016016:Proportional Hazards Models D011446:Prospective Studies D018570:Risk Assessment D012307:Risk Factors D016896:Treatment Outcome D054556:Venous Thromboembolism D020246:Venous Thrombosis D055815:Young Adult
venous thromboembolism disability risk deep vein thrombosis