Dataset Information

Sociodemographic, labour market marginalisation and medical characteristics as risk factors for reinfarction and mortality within 1 year after a first acute myocardial infarction: a register-based cohort study of a working age population in Sweden.

ABSTRACT:

Objectives

Research covering a wide range of risk factors related to the prognosis during the first year after an acute myocardial infarction (AMI) is insufficient. This study aimed to investigate whether sociodemographic, labour market marginalisation and medical characteristics before/at AMI were associated with subsequent reinfarction and all-cause mortality.

Design

Population-based cohort study.

Participants

The cohort included 15 069 individuals aged 25-64 years who had a first AMI during 2008-2010.

Primary and secondary outcome measures

The outcome measures consisted of reinfarction and all-cause mortality within 1?year following an AMI, which were estimated by univariate and multivariable HRs and 95% CIs by Cox regression.

Results

Sociodemographic characteristics such as lower education showed a 1.1-fold and 1.3-fold higher risk for reinfarction and mortality, respectively. Older age was associated with a higher risk of mortality while being born in non-European countries showed a lower risk of mortality. Labour market marginalisation such as previous long-term work disability was associated with a twofold higher risk of mortality. Regarding medical characteristics, ST-elevation myocardial infarction was predictive for reinfarction (HR: 1.14, 95%?CI: 1.07 to 1.21) and all-cause mortality (HR: 3.80, 95%?CI: 3.08 to 4.68). Moreover, diabetes mellitus, renal insufficiency, stroke, cancer and mental disorders were associated with a higher risk of mortality (range of HRs: 1.24-2.59).

Conclusions

Sociodemographic and medical risk factors were identified as risk factors for mortality and reinfarction after AMI, including older age, immigration status, somatic and mental comorbidities. Previous long-term work disability and infarction type provide useful information for predicting adverse outcomes after AMI during the first year, particularly for mortality.

SUBMITTER: Wang M

PROVIDER: S-EPMC6937026 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Publications

Sociodemographic, labour market marginalisation and medical characteristics as risk factors for reinfarction and mortality within 1 year after a first acute myocardial infarction: a register-based cohort study of a working age population in Sweden.

Wang Mo M Vaez Marjan M Dorner Thomas Ernst TE Rahman Syed Ghulam SG Helgesson Magnus M Ivert Torbjörn T Mittendorfer-Rutz Ellenor E

BMJ open 20191218 12

<h4>Objectives</h4>Research covering a wide range of risk factors related to the prognosis during the first year after an acute myocardial infarction (AMI) is insufficient. This study aimed to investigate whether sociodemographic, labour market marginalisation and medical characteristics before/at AMI were associated with subsequent reinfarction and all-cause mortality.<h4>Design</h4>Population-based cohort study.<h4>Participants</h4>The cohort included 15 069 individuals aged 25-64 years who ha ...[more]

PMID: 31857317

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Project description:OBJECTIVES:Sickness absence after mild traumatic brain injury (mTBI) is frequent due to postconcussive symptoms. We examined labour market attachment following mTBI up to 5 years postinjury. DESIGN AND SETTING:Nationwide cohort study with register follow-up. PARTICIPANTS:Patients between 18 and 60 years with mTBI (International Classification of Diseases, version 10 diagnosis S06.0) were extracted from the Danish National Patient Register (n=19 732). Controls were matched on sex, age and municipality (n=18 640). Patients with spinal cord and column injuries, traumatic brain injury and concussions 5?years preinjury or as secondary diagnosis to the concussion in the inclusion period were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES:Data were extracted from the Danish Register for Evaluation of Marginalization. Primary outcome was 'not attending ordinary work' defined as receiving any social transfer payment. Secondary outcomes were health-related benefits, limited attachment to the labour market, permanent lack of attachment to the labour market and death. RESULTS:5 years after diagnosis, 43% of patients were not attending ordinary work. The odds increased from 6 months (OR 1.30, 95%?CI 1.24 to 1.36) to 5 years (OR 1.54, 95%?CI 1.45 to 1.63). The odds of health-related benefits were 32% (OR 1.32, 95%?CI 1.22 to 1.42) at 6 months and 22% (OR 1.22, 95%?CI 1.12 to 1.33) at 5 years. Limited attachment to the labour market showed increased odds at 5 years (OR 1.38, 95%?CI 1.27 to 1.51) and the odds of permanent lack of attachment to the labour market were higher for patients compared with controls (OR 2.59, 95%?CI 2.30 to 2.92). Death was more than two times higher at 5 years postinjury (OR 2.62, 95%?CI 2.10 to 3.26). CONCLUSIONS:43% of concussed patients were not attending ordinary work 5 years postinjury and received health and social transfer benefits. We conclude that mTBI has a long-term impact on labour market attachment. Prevention and treatment of persisting postconcussive symptoms should be considered. TRIAL REGISTRATION NUMBER:NCT03214432; Results.

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Dataset Information

Sociodemographic, labour market marginalisation and medical characteristics as risk factors for reinfarction and mortality within 1 year after a first acute myocardial infarction: a register-based cohort study of a working age population in Sweden.

Objectives

Design

Participants

Primary and secondary outcome measures

Results

Conclusions

Publications

Sociodemographic, labour market marginalisation and medical characteristics as risk factors for reinfarction and mortality within 1 year after a first acute myocardial infarction: a register-based cohort study of a working age population in Sweden.

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