Length of sick leave as a risk marker of hip fracture: a nationwide cohort study from Sweden

Abstract

<p> Introduction Number of sick leave days is a risk marker for<br /> future health outcomes, but few studies have examined its<br /> association with major public health concerns in old age, such<br /> as osteoporotic fractures. The aim of this prospective, nation-<br /> wide, population-based cohort study based on Swedish regis-<br /> ters was to investigate the association between number of sick<br /> leave days and future risk of hip fracture.<br /> Methods Participants included were all 983,244 individuals<br /> who were living in Sweden on 31 December 1995, aged 50 to<br /> <br /> 64 years, employed, and with no previous hip fracture. Those<br /> with sick leave days in 1995 were compared to those with no<br /> sickness absence. Incidence of hip fracture was followed from<br /> 1996 to 2010.<br /> Results According to Cox regression models adjusted for<br /> sociodemographic factors and morbidity, being on sick<br /> leave more than 3 months, irrespective of cause, was<br /> associated with a 2.0-fold (hazard ratio (HR) 1.96, 95 %<br /> confidence interval (CI) 1.74–2.20) and 1.4-fold (HR 1.40,<br /> 95 % CI 1.27–1.56) increased risk of hip fracture in men<br /> and women, respectively. Analyses repeated among those<br /> with previous non-hip fractures replicated the significant<br /> associations.<br /> Conclusion This nationwide cohort study suggests that sick-<br /> ness absence in working-age women and men is a risk marker<br /> of hip fracture at old ages.</p>