Abstract
It is previously shown that cardiovascular conditions have a negative effect on the ability to work. However, it is unknown if incident atrial fibrillation (AF) influences the ability to work. We examined the association between AF and the risk of work disability and the influence of socioeconomic factors. All Danish residents with a hospital diagnosis of AF and aged ≥30 and ≤63 years in the period January 1, 2000, to September 31, 2014, were included and matched 1:10 with an AF-free gender and age-matched random person from the general population. Permanent social security benefit was used as a marker of work disability. Risk difference (RD) and 95% confidence interval (95% CI) of work disability were calculated over 15 months. The analyses were furthermore stratified in low, medium, and high levels of socioeconomic factors. In total, 28,059 patients with AF and 312,667 matched reference persons were included. The risk of receiving permanent social security benefits within 15 months was 4.5% (4.3% to 4.8%) for the AF cohort and 1.3% (95% CI 1.3% to 1.4%) for the matched reference cohort. Adjusted RD (95% CI) was 2.3% (2.0% to 2.5%). Stratified on income, RDs were higher in low-income groups (adjusted RD 3.7% [95% CI 3.1% to 4.3%]) versus high-income groups (RD 1.3% [1.0% to 1.5%]). In conclusion, the risk of work disability within 15 months after incident AF was more than 3 times as high in patients with AF compared with the general population, especially when comparing individuals in lower socioeconomic strata.
Highlights
Atrial fibrillation (AF) was for many years considered a trivial condition, but it is recognized as a contributor to mortality and morbidity[1] such as heart failure (HF) and stroke.[2]
It is previously shown that cardiovascular conditions such as congenital heart disease,[3] myocardial infarction,[4] HF,5 or cardiac arrest[6] have a negative effect on the ability to work
41,856 patients with AF and corresponding 418,560 AF-free matched individuals aged ≥30 to ≤63 years old were included in the period January 1, 2000 to September 31, 2014
Summary
Atrial fibrillation (AF) was for many years considered a trivial condition, but it is recognized as a contributor to mortality and morbidity[1] such as heart failure (HF) and stroke.[2] the fatal consequences of AF are being increasingly recognized, the social consequences after AF are less examined. Some of the mentioned studies[4−6] reported that high levels of aDepartment of Cardiology, Aalborg University Hospital, Aalborg, Denmark; bAalborg Atrial Fibrillation Study Group, Aalborg University Hospital, Aalborg, Denmark; cDepartment of Clinical Medicine, Aalborg University, Aalborg, Denmark; dDepartment of Social Medicine, Aalborg University Hospital, Aalborg, Denmark; eDanish Center for Clinical Health Services Research, Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark; and fUnit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark.
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