The influence of socio-demographic and clinical factors on sick leave and return to work after open-heart surgery: a nationwide registry-based cohort study

Abstract

Aims: To estimate sick leave (SL) duration after first-time elective open-heart surgery and identify factors contributing to increased SL.

Methods and results: A retrospective nationwide cohort study combined data from the Norwegian Register for Cardiac Surgery and SL data from the Norwegian Labour and Welfare Administrations. All able-bodied adults who underwent first-time elective open-heart surgery in Norway between 2012 and 2021 were followed until 1 year after surgery. The impact of socio-demographic and clinical factors on SL after surgery was analysed using logistic regression and odds ratios. Of 5456 patients, 1643 (30.1%), 1798 (33.0%), 971 (17.8%), 1035 (18.9%), and 9 (0.2%) had SL of <3, 3-6, 6-9, and 9-12 months, and 1 year, respectively. SL >6 months was associated with female gender, primary education only, and average annual income. Post-operative stroke, post-operative renal failure, New York Heart Association Functional Classification system (NYHA) score >3, earlier myocardial infarction, and diabetes mellitus increased the odds of SL >6 months.

Conclusion: This study demonstrates that socio-demographic and clinical factors impact SL after first-time elective open-heart surgery. Patients who experience a stroke or develop renal failure after surgery have the highest odds of SL >6 months. Females and patients with low education levels, earlier myocardial infarction, or NYHA scores III-IV have a two-fold chance of SL >6 months. The findings allow for future investigations of pre- and post-surgery interventions that can most effectively reduce SL and aid return to work.

Keywords: Cardiac surgery; Cohort; Nationwide; Registry study; Registry-based cohort study; Sick leave.