Sick leave after transient ischemic attack among working-age adults in Sweden: A register-based cohort study

A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by focal brain or retinal ischemia, with symptoms resolving within 24 hours and without evidence of acute infarction. This study aims to investigate patterns of sick leave before and after TIA in working-age adults compared with matched general population controls.

This register-based cohort study included all individuals aged ≤66 years treated for TIA in Gothenburg, Sweden, between 2014 and 2019, and age- and sex-matched general population controls (4:1). Data from national registers were used to assess sick leave the year before and after the index event. Logistic regression was used to model associations of sick leave after TIA.

347 individuals with TIA (median age 59 years; 40.6% women) and 1,388 controls were included. Individuals with TIA had more days on sick leave than controls during the year before the event (mean 26 [SD 78] vs. 14 [SD 55], p < 0.001), and increased by 39 days during the year after TIA compared with the year before (95% CI 28-50 days, p < 0.001). The number of individuals on sick leave peaked 14 days after TIA (35.7% vs. 3.4% controls) and remained elevated at 1 year (11.5% vs. 3.8%). The most common registered sick-leave diagnoses 14 days after the event were TIA (43%), stroke (12%), and mental health conditions (13%). Higher income (middle tertile: adjusted OR 2.54, 95% CI 1.22-5.29; highest: 2.11, 1.03-4.34) and employment (adjusted OR 3.11, 1.23-7.88) were associated with sick leave at 14 days.

Over one-third of working-age adults were on sick leave 2 weeks after TIA, and one in ten remained on benefit after one year. Individuals with TIA also tend to have more days on sick leave the year before TIA compared to the general population.