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- Bergkvist, Dan, et al.
(författare)
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Sick leave before and after arthroscopic partial meniscectomy due to traumatic meniscal tear
- 2020
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Ingår i: Osteoarthritis and Cartilage Open. - : Elsevier BV. - 2665-9131. ; 2:2
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Tidskriftsartikel (refereegranskat)abstract
- Summary Objective There is limited knowledge on sick leave associated with arthroscopic partial meniscectomy (APM) due to traumatic meniscal tear and its potential gender differences. Thus, our aim was to determine gender-specific sick leave before and after APM. Method In Skåne region, Sweden, we identified patients, aged 18–59 years diagnosed with traumatic meniscal tear without ligament injury, who had APM during 2004–2012. For each patient, we randomly sampled four age- and sex-matched reference subjects from the general population. We retrieved social insurance register data of all-cause sick leave exceeding two weeks. We analyzed the proportions and duration of sick leave with respect to days of sick leave, age, and gender. Results The cohort comprised 604 patients (29% women), mean (SD) age 40 (11) years, and 2254 reference subjects. Thirty-nine percent of women and 27% of men had a sick leave period longer than 14 days after APM. Still, we found that a new period of sick leave longer than 14 days, initiated on the day of APM (and not before), was relatively uncommon and equally distributed (15%) between women and men. Conclusion About one-third of the patients have more than 2 weeks of sick leave after APM for a traumatic meniscal tear and women are overrepresented in this category. Prolonged sick leave initiated on the day of APM was relatively uncommon. Other factors than surgery seem to explain the prolonged sick leave.
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- Granstam, Elisabet, et al.
(författare)
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Gastric bypass surgery reduced the risk for diabetic retinopathy in patients with type 2 diabetes : A nationwide observational study
- 2019
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Konferensbidrag (refereegranskat)abstract
- Purpose: Diverging results have been reported with regards to the occurrence and progression of diabetic retinopathy following gastric bypass surgery (GBP) in patients with diabetes. We aimed to investigate the incidence of diabetic ocular complications in a nationwide study in Sweden in obese patients with type 2 diabetes mellitus (T2DM) following GBP and compared to a matched cohort of patients with T2DM not subjected to GBP surgery.Setting: Nationwide registry study in Sweden.Methods: We used data from two nationwide registers in Sweden: the Scandinavian Obesity Surgery Registry (SOReg) and the National Diabetes Registry (NDR). Patients with T2DM who had undergone GBP 2007-2013 reported to the SOReg were matched (1:1) with patients with T2DM from the NDR who had not had GBP surgery for obesity, based on sex, age, body mass index (BMI) and calender time (year). Follow-up data were obtained until December 31, 2015. The main outcome was occurrence of new diabetic retinopathy and was assessed with Cox proportional-hazards regression model. The importance of potential risk factors was assessed using a machine learning approach.Results: The study population consisted of 5321 patients who had undergone GBP and 5321 matched controls in NDR, and was followed up for a mean of 4.5 years. Mean age was 49.0 (SD 9.5) in the GBP and 47.1 (11.5) years in the control patients, respectively. BMI and HbA1c at baseline were 42.0 (5.7) and 60.0 (16.8) in the GBP group and 40.9 (7.3) kg/m2 and 58.5 (16.9) mmol/mol in the control group. Duration of diabetes was approximately 6 years in both groups. The risk for new diabetic retinopathy was reduced in the GBP patients (hazard ratio [HR] 0·62, 95% CI 0·49–0·78; p<0.001). The most important risk factors for development of diabetic retinopathy were diabetes duration, HbA1c, glomerular filtration rate (GFR), use of insulin and BMI. There was no evidence of increased risk for development of sight-threatening or treatment-requiring diabetic ocular complications such as diabetic macular edema, proliferative diabetic retinopathy, need for intravitreal drug administration, panretinal photocoagulation or vitrectomy.Conclusions: In this nationwide large cohort study of patients with type 2 diabetes we found a beneficial effect of GBP surgery on the risk for development of diabetic retinopathy. Furthermore, there were no indications for increased occurrence of sight-threatening or treatment-requiring diabetic retinopathy. These data provide support that, besides standard screening for diabetic retinopathy, there is no need for extended ophthalmological surveillance of patients with type 2 diabetes undergoing GBP surgery.
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- Gustafsson, Kristin, 1976-, et al.
(författare)
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Health status of individuals referred to first-line intervention for hip and knee osteoarthritis compared with the general population: an observational register-based study
- 2021
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Ingår i: Bmj Open. - London, United Kingdom : BMJ. - 2044-6055. ; 11:9
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To describe the prevalence of comorbidities in a population referred to standardised first-line intervention (patient education and exercise) for hip and knee osteoarthritis (OA), in comparison with the general population. Furthermore, we aimed to evaluate if eventual differences were associated with socioeconomic inequalities. Design Register-based study. Setting Primary healthcare, Sweden. Participants Individuals with hip and/or knee OA included in the Better Management for Patients with Osteoarthritis Register between 2008 and 2016 and and an age-matched, sex-matched and residence-matched reference cohort (1:3) from the general Swedish population. Outcome measures Comorbidities were identified with the RxRisk Index, the Elixhauser Comorbidity Index and the Charlson Comorbidity Index, and presented with descriptive statistics as (1) individual diseases, (2) disease categories and (3) scores for each index. The prevalence of comorbidities in the two populations was tested using logistic regression, with separate analyses for age groups and the most affected joint. We then adjusted the analyses for socioeconomic status. Results In this OA population, 85% had >= 1 comorbidity compared with 78% of the reference cohort (OR; 1.62 (95% CI 1.59 to 1.66)). Cardiovascular/blood diseases were the most common comorbidities in both populations (OA, 59%; reference, 54%), with OR; 1.22 (95% CI 1.20 to 1.24) for the OA population. Younger individuals with OA were more comorbid than their matched references overall, and population differences decreased with age (eg, >= 3 comorbidities, aged <= 45 years OR; 1.74 (95% CI 1.52 to 1.98), >= 81 years OR; 0.95 (95% CI 0.87 to 1.04)). Individuals with knee OA were more comorbid than those with hip OA overall. Adjustment for socioeconomic status did not change the estimates. Conclusion Comorbidities were more common among individuals with hip and knee OA than among matched references from the general population. The differences could not be explained by socioeconomic status.
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- Stigmar, Kjerstin, et al.
(författare)
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Sick leave in Sweden before and after total joint replacement in hip and knee osteoarthritis patients
- 2017
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 88:2, s. 152-157
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Little is know about patterns of sick leave in connection with total hip and knee joint replacement (THR and TKR) in patients with osteoarthritis (OA). Patients and methods - Using registers from southern Sweden, we identified hip and knee OA patients aged 40-59 years who had a THR or TKR in the period 2004-2012. Patients who died or started on disability pension were excluded. We included 1,307 patients with THR (46% women) and 996 patients with TKR (56% women). For the period 1 year before until 2 years after the surgery, we linked individual-level data on sick leave from the Swedish Social Insurance Agency. We created a matched reference cohort from the general population by age, birth year, and area of residence (THR: n = 4,604; TKR: n = 3,425). The mean number of days on sick leave and the proportion (%) on sick leave 12 and 24 months before and after surgery were calculated. Results - The month after surgery, about 90% of patients in both cohorts were on sick leave. At the two-year follow-up, sick leave was lower for both cohorts than 1 year before surgery, except for men with THR, but about 9% of the THR patients and 12-17% of the TKR patients were still sick-listed. In the matched reference cohorts, sick leave was constant at around 4-7% during the entire study period. Interpretation - A long period of sick leave is common after total joint replacement, especially after TKR. There is a need for better knowledge on how workplace adjustments and rehabilitation can facilitate the return to work and can postpone surgery.
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- Timpka, Simon, et al.
(författare)
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Muscle strength in adolescent men and future musculoskeletal pain: a cohort study with 17 years of follow-up.
- 2013
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 3:5
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Tidskriftsartikel (refereegranskat)abstract
- Musculoskeletal pain is highly prevalent throughout adulthood with a major impact on health, function and participation in the society. Still, the association between muscle strength and development of musculoskeletal pain is unclear. We aimed to study whether overall muscle strength in adolescent men is inversely associated with self-reported musculoskeletal pain in adulthood.
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| 9. |
- Timpka, Simon, et al.
(författare)
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Muscle strength in adolescent men and risk of cardiovascular disease events and mortality in middle age: a prospective cohort study
- 2014
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Ingår i: BMC Medicine. - : Springer Science and Business Media LLC. - 1741-7015. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Ischemic heart disease and stroke are two severe types of cardiovascular disease (CVD), a major contributor to the global burden of disease. The preventive framework currently includes promotion of both adequate cardiorespiratory and muscular fitness. Although muscle fitness is established as an indicator of health, it is currently unknown whether muscle strength is associated with later CVD independently of cardiorespiratory fitness. Methods We studied 38,588 Swedish men who in 1969 to 1970 (typically aged 18 years) completed compulsory conscription. Using the mean standardized score of three isometric muscle strength tests performed at conscription (hand grip, elbow flexion and knee extension), we categorized the subjects into three groups with the 25th to 75th percentile defining the reference category. We followed the cohort until 2012 for diagnosed CVD events and mortality via national health care registers and the national cause of death register. To estimate hazard ratios (HR) for CVD events (coronary heart disease or stroke) and CVD mortality we used Cox proportional hazard models adjusted for body mass index, smoking, alcohol consumption, cardiorespiratory fitness and socioeconomic status. Results Men with high muscle strength in adolescence had a decreased risk of later CVD events (HR 0.88, 95% confidence interval 0.77 to 0.99), whereas we observed no increased risk in men with low muscle strength (0.99, 0.86 to 1.13). However, low muscle strength was associated with increased risk of CVD mortality during middle age (1.31, 1.02 to 1.67). Conclusions Muscle strength in adolescent men is inversely associated with later CVD events and CVD mortality in middle age, independently of cardiorespiratory fitness and other important confounders. Thus, the role of muscle fitness in the prevention and pathogenesis of CVD warrants increased attention.
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- Vanfleteren, Lowie E G W, et al.
(författare)
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Exacerbation Risk and Mortality in COPD GOLD Group A and B Patients with and without Exacerbation History.
- 2023
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Ingår i: American journal of respiratory and critical care medicine. - 1535-4970. ; 208:2, s. 163-75
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Tidskriftsartikel (refereegranskat)abstract
- Risk stratification of patients according to COPD severity is clinically important and forms the basis of therapeutic recommendations. No studies have examined the association for GOLD group A and B patients with (A1, B1) and without (A0, B0) an exacerbation in the last year with future exacerbations, hospitalizations, and mortality in perspective of the new GOLD ABE classification.In this nationwide cohort study, we identified patients with a diagnosis of COPD, aged ≥ 30 years, registered in the Swedish National Airway Register between January 2017 and August 2020. Patients were stratified in GOLD groups A0, A1, B0, B1 and E, and followed until January 2021 for exacerbations, hospitalization, and mortality in national registries.The 45350 eligible patients included 25% A0, 4% A1, 44% B0, 10% B1, and 17% E. Moderate exacerbations, all-cause and respiratory hospitalizations, and all-cause and respiratory mortality increased by GOLD group A0-A1-B0-B1-E, except for moderate exacerbations which was higher in A1 than B0. Group B1 had substantially higher hazard ratio of future exacerbation (2.56, 95%CI 2.40-2.74), all-cause hospitalization (1.28, 1.21-1.35), respiratory hospitalization (1.44, 1.27-1.62), but not all-cause (1.04, 0.91-1.18) or respiratory mortality (1.13, 0.79-1.64) than group B0. The exacerbation rate for group B1 was 0.6 events/patient-year versus 0.2 for B0 (rate ratio 2.73, 95%CI 2.57-2.79). Results were similar for group A1 versus A0.Stratification of GOLD A and B patients with one or no exacerbation in the last year provides valuable information on future risk, which should influence treatment recommendations for preventive strategies.
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