Prevalence of sick leave before and after pituitary adenoma surgery

The aims of this study were to evaluate sickness compensation before and after transsphenoidal surgery (TSS) for pituitary adenoma compared to the general population and to identify factors associated with return to work (RTW) after TSS.

This study included working-age patients who had undergone TSS for a pituitary adenoma at Sahlgrenska University Hospital and matched controls (1:5) from the general population in Sweden. Data for sickness compensation from 1 year before TSS (index) to up to 2 years after was obtained from national registers. Demographic factors, cognition, and fatigue were evaluated based on impact on number of days to RTW or by comparing the groups of patients with and without RTW 1-year post-surgery.

Sixty-six patients and 329 matched controls were included. The proportion of patients with sickness compensation was approximately twice that of controls 1 year prior to TSS. The proportion of patients with sickness compensation continued to increase until TSS and decreased thereafter but did not return to the level observed 1 year prior to TSS. Prior sickness compensation and Cushing's disease, albeit this subgroup was small, were predictive of more days to RTW after TSS. Patients without RTW 1-year post-surgery reported more fatigue and more often had adrenal insufficiency compared to the group of patients with RTW.

Sickness compensation for patients with pituitary adenoma is mainly limited to the surgical period and the months thereafter. Sustained higher levels 1-year post-surgery suggest that work disability remains a long-term issue for a subgroup of patients.