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 multi-variate 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. (C) 2012 AEC. Published by Elsevier Espana, S. L. All rights reserved.