Periodo prequirúrgico y duración de la incapacidad temporal por contingencias comunes en la hernia inguinal / Pre-surgical period and non-work-related sickness absence due to inguinal hernia

FUNDAMENTO Y OBJETIVO: Analizar la incapacidad temporal por contingencias comunes (ITCC) debida a hernia inguinal y los factores relacionados con su duración, prestando especial atención al periodo prequirúrgico de ITCC. MATERIAL Y MÉTODOS: Estudio de una cohorte prospectiva de 1.003 trabajadores con un episodio de ITCC por hernia inguinal, pertenecientes a la población protegida de una mutua de accidentes de trabajo y enfermedades profesionales. Se evaluaron la duración de la ITCC y las principales variables demográficas, laborales y clínicas potencialmente relacionadas con aquella. Se establecieron predictores de la duración de la ITCC mediante regresión de Cox. RESULTADOS: La duración media de la ITCC por hernia inguinal fue de 68,6 días. Tras el análisis multivariante, tener periodo prequirúrgico de ITCC (HR = 0,35; IC 95%: 0,28-0,43), las ocupaciones manuales (HR = 0,68; IC 95%: 0,49-0,95), pertenecer al sector Construcción (HR = 0,71; IC 95%: 0,58-0,88), la modalidad de pago directo por la mutua en trabajadores por cuenta propia (HR = 0,58; IC 95%: 0,41-0,82) o ajena (HR = 0,51; IC 95%: 0,36-0,72), la presencia de comorbilidad (HR = 0,45; IC 95%: 0,34-0,59) y la realización de la cirugía por una entidad distinta del Sistema Público de Salud o la mutua (HR = 0,76; IC 95%: 0,59-0,97) se asociaron con bajas más largas. La mutua realizó la cirugía, siempre en presencia de periodo de ITCC prequirúrgica (duración media = 47 ± 39,6 días), asociándose periodos de ITCC posquirúrgica más breves (p = 0,001). CONCLUSIONES: La ITCC por hernia inguinal es un fenómeno multifactorial en el que el periodo prequirúrgico desempeña un papel importante. La colaboración entre entidades implicadas en la gestión de la ITCC parece resultar una estrategia efectiva para reducir su duración

BACKGROUND AND OBJECTIVE: To analyze non-work-related sickness absence (NWR-SA) due to inguinal hernia and the factors related to its duration, paying particular attention to the pre-surgical period of NWR-SA. MATERIAL AND METHODS: Prospective cohort study was conducted on 1,003 workers with an episode of NWR-SA due to an inguinal hernia, belonging to the insured population of a mutual insurance company. We assessed the duration of the NWR-SA episodes and the main demographic, occupational and clinical variables potentially related to it. Cox regression analyses were conducted to establish the predictors of NWR-SA duration. RESULTS: The mean duration of NWR-SA due to inguinal hernia was 68.6 days. After multivariate analysis (Cox regression), having a pre-surgical period of NWR-SA (HR = 0.35; 95% CI: 0.28-0.43), manual occupations (HR = 0.68; 95% CI: 0.49-0.95), construction sector (HR = 0.71; 95%CI: 0.58-0.88), direct payment methods by a Mutual Insurance Company during sick leave in self-employed workers (HR = 0.58; 95% CI, 0.41-0.82), or employees (HR = 0.51; 95% CI: 0.36-0.72), comorbidity (HR = 0.45; 95% CI:0.34-0.59), and surgery performed under an entity other than the Public Health System or a mutual insurance company (HR=0,76; 95%CI: 0.59-0.97) were associated with longer NWR-SA. The Mutual Insurance Company always performed the surgery when a pre-surgery period of NWR-SA existed (mean duration = 47 ± 39.6 days); that was associated with shorter periods of post-surgical NWR-SA (P = .001). CONCLUSIONS: The NWR-SA due to inguinal hernia is a multifactorial phenomenon in which the pre-surgery period plays an important role. The collaboration between organizations involved in the management of NWR-SA seems to be an effective strategy for reducing its duration

[Pre-surgical period and non-work-related sickness absence due to inguinal hernia]. / Periodo prequirúrgico y duración de la incapacidad temporal por contingencias comunes en la hernia inguinal.

BACKGROUND AND OBJECTIVE: To analyze non-work-related sickness absence (NWR-SA) due to inguinal hernia and the factors related to its duration, paying particular attention to the pre-surgical period of NWR-SA. MATERIAL AND METHODS: Prospective cohort study was conducted on 1,003 workers with an episode of NWR-SA due to an inguinal hernia, belonging to the insured population of a mutual insurance company. We assessed the duration of the NWR-SA episodes and the main demographic, occupational and clinical variables potentially related to it. Cox regression analyses were conducted to establish the predictors of NWR-SA duration. RESULTS: The mean duration of NWR-SA due to inguinal hernia was 68.6 days. After multivariate analysis (Cox regression), having a pre-surgical period of NWR-SA (HR = 0.35; 95%CI: 0.28-0.43), manual occupations (HR=0.68; 95%CI: 0.49-0.95), construction sector (HR=0.71; 95%CI: 0.58-0.88), direct payment methods by a Mutual Insurance Company during sick leave in self-employed workers (HR=0.58; 95%CI, 0.41-0.82), or employees (HR=0.51; 95%CI: 0.36-0.72), comorbidity (HR=0.45; 95%CI:0.34-0.59), and surgery performed under an entity other than the Public Health System or a mutual insurance company (HR=0,76; 95%CI: 0.59-0.97) were associated with longer NWR-SA. The Mutual Insurance Company always performed the surgery when a pre-surgery period of NWR-SA existed (mean duration=47 ±39.6 days); that was associated with shorter periods of post-surgical NWR-SA (P=.001). CONCLUSIONS: The NWR-SA due to inguinal hernia is a multifactorial phenomenon in which the pre-surgery period plays an important role. The collaboration between organizations involved in the management of NWR-SA seems to be an effective strategy for reducing its duration.