Organ support therapy in the intensive care unit and return to work: a nationwide, register-based cohort study

  • Signe Riddersholm
  • Steffen Christensen
  • Kristian Kragholm
  • Christian F. Christiansen
  • Bodil Steen Rasmussen
Original
First Online:
Received:
Accepted:

Abstract

Purpose

The association between severity of illness and ability to return to work is unclear. Therefore, we investigated return to work and associations with measures of illness severity in ICU survivors.

Methods

We conducted this cohort study using Danish registry data for the period 2005–2014 on ICU patients who were discharged alive from hospital, had an ICU length of stay (LOS) of at least 72 h, were not treated with dialysis before hospital admission and were working prior to admission. We assessed (1) the cumulative incidence (chance) of return to work (2005–2017) and receipt of social benefits after discharge from a hospital stay with ICU admission and (2) the association between organ support therapies (renal replacement therapy, cardiovascular support and mechanical ventilation), and during 2011–2014 SAPS II and ICU LOS, and return to work, using multivariable Cox regression.

Results

Among 5762 ICU survivors, 68% returned to work within 2 years after hospital discharge. Disability and sickness benefits constituted 89% of social benefits among patients not returning to work and 59% among patients withdrawing from work following an initial return to work. Mechanical ventilation (HR 0.70, 95% CI [0.65–0.77]), but not RRT (HR 0.85, 95% CI [0.71–1.02]), cardiovascular support (HR 0.93, 95% CI [0.82–1.07]) and increasing SAPS II, was associated with decreased chance of return to work. Increasing ICU LOS was also associated with a decreased chance of return to work.

Conclusions

The majority of a nationwide cohort of ICU survivors returned to work. Sick leave and receipt of disability pension were common following ICU admission. Mechanical ventilation and longer ICU LOS were associated with reduced chances of return to work.

Keywords

Organ support therapy Return to work Disability Income Long-term outcome 
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Notes

Acknowledgements

We thank the Danish ICUs for reporting data on organ support treatments, ICU admission and SAPS II scores to the Danish National Registry of Patients according to the definitions made by the Danish Intensive Care Database.

Compliance with ethical standards

Conflicts of interest

The corresponding author has no conflicts of interests to disclosure. Dr. Kragholm has received research grants from the Danish Heart Foundation, the Laerdal Foundation and the Fund of Herta Christensen, Denmark, and has received speaker’s honoraria from Novartis. Dr. Rasmussen has received research grants from Innovation Fund Denmark. None of these institutions or companies had any influence on the conduct or design of the study; the collection, management, analysis and interpretation of the data; or the preparation, review or approval of the manuscript for submission. All other authors have no conflicts of interests to disclose.

Supplementary material

134_2018_5157_MOESM1_ESM.docx (754 kb)
Supplementary material 1 (DOCX 753 kb)
134_2018_5157_MOESM2_ESM.docx (21 kb)
Supplementary material 2 (DOCX 20 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature and ESICM 2018

Authors and Affiliations

  • Signe Riddersholm
    • 1
    • 2
  • Steffen Christensen
    • 3
  • Kristian Kragholm
    • 4
    • 5
  • Christian F. Christiansen
    • 6
  • Bodil Steen Rasmussen
    • 1
    • 2
  1. 1.Department of Anaesthesiology and Intensive Care MedicineAalborg University HospitalAalborgDenmark
  2. 2.Clinical InstituteAalborg UniversityAalborgDenmark
  3. 3.Department of Anaesthesiology and Intensive Care MedicineAarhus University HospitalAarhusDenmark
  4. 4.Department of CardiologyAalborg University HospitalAalborgDenmark
  5. 5.Unit of Epidemiology and BiostatisticsAalborg University HospitalAalborgDenmark
  6. 6.Department of Clinical EpidemiologyAarhus University HospitalAarhusDenmark

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