Predictors of long-term employment among patients with cystic fibrosis undergoing lung transplantation
AIMS OF THE STUDY Lung transplantation is an established therapy in selected patients with advanced cystic fibrosis lung disease. Resumption of employment after lung transplantation is generally supported. In Switzerland, there are no data on long-term employment in people with cystic fi...
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2020-07-01
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Series: | Swiss Medical Weekly |
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Online Access: | https://www.smw.ch/index.php/smw/article/view/2835 |
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author | Thomas Radtke André Königs Xijin Chen Julia Braun Holger Dressel Christian Benden |
author_facet | Thomas Radtke André Königs Xijin Chen Julia Braun Holger Dressel Christian Benden |
author_sort | Thomas Radtke |
collection | DOAJ |
description |
AIMS OF THE STUDY
Lung transplantation is an established therapy in selected patients with advanced cystic fibrosis lung disease. Resumption of employment after lung transplantation is generally supported. In Switzerland, there are no data on long-term employment in people with cystic fibrosis undergoing lung transplantation.
METHODS
In a single-centre, cross-sectional study at a Swiss university hospital, clinical data from lung transplant recipients with cystic fibrosis, covering the transplantation period from January 1996 to December 2016, were analysed retrospectively. The potential influence of pre-lung transplantation factors (age, sex, lung function, body mass index, six-minute walk test distance, lung transplantation wait list time, paid employment on the wait list, education, relationship status, housing situation) and post-lung transplantation factors (chronic allograft dysfunction [CLAD], dialysis, cancer diagnosis [except skin cancer]) on paid employment and work percentage after lung transplantation were investigated using mixed logistic and linear regression models. Descriptive analyses of paid employment were performed for various periods after lung transplantation (<1, 1–3, 3–5, 5–10, >10 years). Data are reported as odds ratios (ORs) or coefficients (β) with their 95% confidence intervals (CIs).
RESULTS
Eighty-four subjects (46.4% female) with a mean ± SD age of 29.9 ± 8.4 years were included in the study. Mean wait time for lung transplantation was 42.7 ± 40.2 weeks. The number (percentage) of subjects employed <1 year, 1–3 years, 3–5 years, 5–10 years and >10 years after lung transplantation was n = 23 (28%), n = 51 (65%), n = 44 (75%), n = 30 (68%) and n = 21 (75%), respectively. In mixed logistic regression models, pre-lung transplantation paid employment (OR 24.03, 95% CI 6.08 to 164.39, p <0.0001), academic education (OR 7.81, 95% CI 1.66 to 48.66, p = 0.01) and time post lung transplantation (on log scale, OR 5.81, 95% CI 3.15 to 12.78, p <0.0001) were the main factors influencing post-lung transplantation paid employment status. In mixed linear regression models, pre-lung transplantation paid employment (β = 21.40, 95% CI 10.98 to 31.81, p = 0.00014), academic education (β = 12.54, 95% CI 0.48 to 24.55, p = 0.05) and time post lung transplantation (on log scale, β = 8.96, 95% CI 6.17 to 11.82, p <0.0001) were the main factors influencing work percentage post lung transplantation. No evidence for an influence of clinical factors such as CLAD, cancer or dialysis on post-lung transplantation employment and work percentage was found.
CONCLUSION
Pre-transplant employment is the dominant factor influencing lung transplantation employment in people with cystic fibrosis. People with cystic fibrosis undergoing lung transplantation should be encouraged to work for as long as their health status permits. Professional reintegration after successful lung transplantation should be supported by a multi-disciplinary lung transplant team.
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issn | 1424-3997 |
language | English |
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spelling | doaj.art-73beffa6241a45a4b37e1e2de559659d2022-12-29T16:02:42ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972020-07-01150293010.4414/smw.2020.20286Predictors of long-term employment among patients with cystic fibrosis undergoing lung transplantationThomas Radtke0André Königs1Xijin Chen2Julia Braun3Holger Dressel4Christian Benden5Division of Occupational and Environmental Medicine, Epidemiology, Biostatistics and Prevention Institute, University of Zurich and University Hospital Zurich, SwitzerlandDivision of Pulmonology, University Hospital Zurich, SwitzerlandDepartment of Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, SwitzerlandDepartment of Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, SwitzerlandDivision of Occupational and Environmental Medicine, Epidemiology, Biostatistics and Prevention Institute, University of Zurich and University Hospital Zurich, SwitzerlandUniversity of Zurich, Switzerland AIMS OF THE STUDY Lung transplantation is an established therapy in selected patients with advanced cystic fibrosis lung disease. Resumption of employment after lung transplantation is generally supported. In Switzerland, there are no data on long-term employment in people with cystic fibrosis undergoing lung transplantation. METHODS In a single-centre, cross-sectional study at a Swiss university hospital, clinical data from lung transplant recipients with cystic fibrosis, covering the transplantation period from January 1996 to December 2016, were analysed retrospectively. The potential influence of pre-lung transplantation factors (age, sex, lung function, body mass index, six-minute walk test distance, lung transplantation wait list time, paid employment on the wait list, education, relationship status, housing situation) and post-lung transplantation factors (chronic allograft dysfunction [CLAD], dialysis, cancer diagnosis [except skin cancer]) on paid employment and work percentage after lung transplantation were investigated using mixed logistic and linear regression models. Descriptive analyses of paid employment were performed for various periods after lung transplantation (<1, 1–3, 3–5, 5–10, >10 years). Data are reported as odds ratios (ORs) or coefficients (β) with their 95% confidence intervals (CIs). RESULTS Eighty-four subjects (46.4% female) with a mean ± SD age of 29.9 ± 8.4 years were included in the study. Mean wait time for lung transplantation was 42.7 ± 40.2 weeks. The number (percentage) of subjects employed <1 year, 1–3 years, 3–5 years, 5–10 years and >10 years after lung transplantation was n = 23 (28%), n = 51 (65%), n = 44 (75%), n = 30 (68%) and n = 21 (75%), respectively. In mixed logistic regression models, pre-lung transplantation paid employment (OR 24.03, 95% CI 6.08 to 164.39, p <0.0001), academic education (OR 7.81, 95% CI 1.66 to 48.66, p = 0.01) and time post lung transplantation (on log scale, OR 5.81, 95% CI 3.15 to 12.78, p <0.0001) were the main factors influencing post-lung transplantation paid employment status. In mixed linear regression models, pre-lung transplantation paid employment (β = 21.40, 95% CI 10.98 to 31.81, p = 0.00014), academic education (β = 12.54, 95% CI 0.48 to 24.55, p = 0.05) and time post lung transplantation (on log scale, β = 8.96, 95% CI 6.17 to 11.82, p <0.0001) were the main factors influencing work percentage post lung transplantation. No evidence for an influence of clinical factors such as CLAD, cancer or dialysis on post-lung transplantation employment and work percentage was found. CONCLUSION Pre-transplant employment is the dominant factor influencing lung transplantation employment in people with cystic fibrosis. People with cystic fibrosis undergoing lung transplantation should be encouraged to work for as long as their health status permits. Professional reintegration after successful lung transplantation should be supported by a multi-disciplinary lung transplant team. https://www.smw.ch/index.php/smw/article/view/2835lung transplantationworking for incomelung disease |
spellingShingle | Thomas Radtke André Königs Xijin Chen Julia Braun Holger Dressel Christian Benden Predictors of long-term employment among patients with cystic fibrosis undergoing lung transplantation Swiss Medical Weekly lung transplantation working for income lung disease |
title | Predictors of long-term employment among patients with cystic fibrosis undergoing lung transplantation |
title_full | Predictors of long-term employment among patients with cystic fibrosis undergoing lung transplantation |
title_fullStr | Predictors of long-term employment among patients with cystic fibrosis undergoing lung transplantation |
title_full_unstemmed | Predictors of long-term employment among patients with cystic fibrosis undergoing lung transplantation |
title_short | Predictors of long-term employment among patients with cystic fibrosis undergoing lung transplantation |
title_sort | predictors of long term employment among patients with cystic fibrosis undergoing lung transplantation |
topic | lung transplantation working for income lung disease |
url | https://www.smw.ch/index.php/smw/article/view/2835 |
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