Do Danish ICU Survivors Remain Employed after ICU Discharge? A Register-Based Longitudinal Cohort Study

Objectives: Admission to ICU is associated with long-term consequences for the survivors. The study explores whether Danish ICU survivors remain employed after ICU discharge. Design: A longitudinal register study of 16,284 Danish ICU survivors 25-67 years old 1:1 sex- and age-matched with general population references. Weekly prevalence proportions (%) of employed, public benefits, and deceased individuals were calculated based on the Danish Register-Based Evaluation and Marginalization Database and the Danish Civil Registration System until December 31, 2019. Age- and multivariate-adjusted hazard ratios (HRs) with 95% CIs were determined by Cox and Fine-Gray models. Setting: Denmark has tax-funded healthcare and social security ensuring hospital treatment and social benefits free of charge for all Danish residents. SUBJECTS: The study included Danish residents acutely admitted to public ICU treatment for critical illness from 2010 to 2018. Interventions: None. Measurements and Main Results: The prevalences of employed ICU survivors increased from 30% at 2-8 weeks to 56% at 52 weeks after ICU discharge showing minor delay in women. The prevalences declined by age being 63%, 58%, 55%, and 52% in ages 25-42, 43-52, 53-58, and 59-63 years, respectively, 52 weeks after ICU discharge. The prevalences of employed ICU survivors declined by level of comorbidity being 64%, 53%, and 37% in ICU survivors of Charlson Comorbidity Index score 0, 1-2, or greater than or equal to 3, respectively, 52 weeks after ICU discharge. ICU survivors had higher risks of becoming retired (HR, 14.86; 95% CI, 8.69-25.41) or sickness absent (HR, 7.56; 95% CI, 7.16-7.98) when accounting for competing risks compared with the general population references. Conclusions: About half of ICU survivors remained employed 52 weeks after ICU discharge. Age and comorbidity were effect modifiers.