TY - JOUR

T1 - Workforce Attachment after Ischemic Stroke – The Importance of Time to Thrombolytic Therapy

AU - Butt, Jawad H.

AU - Kragholm, Kristian

AU - Kruuse, Christina

AU - Christensen, Hanne

AU - Iversen, Helle K.

AU - Johnsen, Søren Paaske

AU - Rørth, Rasmus

AU - Vinding, Naja Emborg

AU - Yafasova, Adelina

AU - Christiansen, Christine Benn

AU - Gislason, Gunnar H.

AU - Torp-Pedersen, Christian

AU - Køber, Lars

AU - Fosbøl, Emil L.

N1 - Funding Information: We thank The Danish Clinical Quality Program ? National Clinical Registries (RKKP) for making it possible to work with The Danish Stroke Registry. None. None. Data for this study are derived from Statistics Denmark. By law, these data are not allowed to be shared. Therefore, data cannot not be made available to other researchers. Publisher Copyright: © 2021 The Author(s)

PY - 2021

Y1 - 2021

N2 - Objectives: The ability to remain in employment addresses an important consequence of stroke beyond the usual clinical parameters. However, data on the association between time to intravenous thrombolysis and workforce attachment in patients with acute ischemic stroke are sparse. Materials and methods: In this nationwide cohort study, stroke patients of working age (18-60 years) treated with thrombolysis (2011-2016) who were part of the workforce prior to admission and alive at discharge were identified using the Danish Stroke Registry. The association between time to thrombolysis and workforce attachment one year later was examined with multivariable logistic regression. Results: The study population comprised 1,329 patients (median age 51 years [25th-75th percentile 45-56], 67.3% men). The median National Institutes of Health Stroke Scale score at presentation was 4 (25th-75th percentile 2-8), and the median time from symptom-onset to initiation of thrombolysis was 140min (25th-75th percentile 104-196min). The proportion of patients who were part of the workforce at one-year follow-up was 64.6%, 64.3%, 64.9%, and 60.0% in patients receiving thrombolysis within 90min, between 91-180min, between 181-270min, and after 270min, respectively. In adjusted analysis, time to thrombolysis between 91-180min, 181-270min, and >270min was not significantly associated with workforce attachment compared with thrombolysis received ≤90min of symptom-onset (ORs 0.89 [95%CI 0.60-1.31], 0.93 [0.66-1.31], and 0.80 [0.43-1.52], respectively). Conclusions: In patients of working age admitted with stroke and treated with thrombolysis, two out of three were part of the workforce one year after discharge. There was no graded relationship between time to thrombolysis and the likelihood of workforce attachment.

AB - Objectives: The ability to remain in employment addresses an important consequence of stroke beyond the usual clinical parameters. However, data on the association between time to intravenous thrombolysis and workforce attachment in patients with acute ischemic stroke are sparse. Materials and methods: In this nationwide cohort study, stroke patients of working age (18-60 years) treated with thrombolysis (2011-2016) who were part of the workforce prior to admission and alive at discharge were identified using the Danish Stroke Registry. The association between time to thrombolysis and workforce attachment one year later was examined with multivariable logistic regression. Results: The study population comprised 1,329 patients (median age 51 years [25th-75th percentile 45-56], 67.3% men). The median National Institutes of Health Stroke Scale score at presentation was 4 (25th-75th percentile 2-8), and the median time from symptom-onset to initiation of thrombolysis was 140min (25th-75th percentile 104-196min). The proportion of patients who were part of the workforce at one-year follow-up was 64.6%, 64.3%, 64.9%, and 60.0% in patients receiving thrombolysis within 90min, between 91-180min, between 181-270min, and after 270min, respectively. In adjusted analysis, time to thrombolysis between 91-180min, 181-270min, and >270min was not significantly associated with workforce attachment compared with thrombolysis received ≤90min of symptom-onset (ORs 0.89 [95%CI 0.60-1.31], 0.93 [0.66-1.31], and 0.80 [0.43-1.52], respectively). Conclusions: In patients of working age admitted with stroke and treated with thrombolysis, two out of three were part of the workforce one year after discharge. There was no graded relationship between time to thrombolysis and the likelihood of workforce attachment.

KW - Epidemiology

KW - Stroke

KW - Thrombolytic therapy

KW - Workforce

U2 - 10.1016/j.jstrokecerebrovasdis.2021.106031

DO - 10.1016/j.jstrokecerebrovasdis.2021.106031

M3 - Journal article

C2 - 34450481

AN - SCOPUS:85113292120

VL - 30

JO - Journal of Stroke & Cerebrovascular Diseases

JF - Journal of Stroke & Cerebrovascular Diseases

SN - 1052-3057

IS - 11

M1 - 106031

ER -