Image by Andre E.X. Brown
Unprovoked venous thromboembolism (VTE) may increase the risk of permanent work-related disability, according to research published in the Journal of Thrombosis and Haemostasis.
Researchers evaluated data from more than 60,000 people and found that individuals with unprovoked VTE had a 52% higher risk of work-related disability than those without VTE.
However, there was no association between provoked VTE and work-related disability.
In addition, only deep vein thrombosis (DVT)—not pulmonary embolism (PE)—was significantly associated with an increased risk of work-related disability.
For this study, the researchers analyzed data from the Tromsø Study and the Nord-Trøndelag Health Study, which enrolled 66,005 subjects from 1994 to 1997. The subjects’ mean age at inclusion was 41.3 (range, 20-65), and about half (51.2%, n=33,901) were women.
The subjects were followed through 2008. During the follow-up period, 384 individuals had a first VTE, and 9862 received a disability pension due to work-related disability.
Compared to individuals without VTE, those who had a VTE were slightly older and had a higher body mass index. VTE patients were more likely to have a history of cancer and cardiovascular disease, and they were more likely to have paying jobs.
In addition, subjects with VTE were more likely to have work-related disability. The crude incidence rate of disability was 37.5 per 1000 person-years among VTE patients and 13.5 per 1000 person-years among subjects without VTE.
VTE patients who received disability pension were slightly older than those who did not, and a higher proportion of the VTEs were DVTs rather than PEs. Half of the VTEs were unprovoked.
Multivariable analysis suggested that subjects with unprovoked VTE had a 52% higher risk of work-related disability than individuals without VTE (hazard ratio [HR]=1.52). However, there was no association between provoked VTE and work-related disability (HR=0.83).
When the researchers analyzed DVT and PE separately, they found that subjects with DVT had an 80% higher risk of work-related disability than those without DVT (HR=1.80). Subjects with PE had a moderately increased risk of work-related disability that was not statistically significant (HR=1.28).
When the researchers adjusted for baseline characteristics other than self-rated health, the association between work-related disability and DVT remained strong (HR=1.66), and there was no association between work-related disability and PE (HR=1.06).
The researchers said this study is the first of its kind to document a relationship between VTE and subsequent work-related disability. And the findings suggest the economic burden of VTE goes beyond costs to the healthcare system. The loss of economic output from people who are unable to work due to VTE-related complications is also a substantial economic cost of VTE.
