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Effect of surgical versus medical therapy on return to work in patients with coronary artery disease
Insights
Returning to work after coronary artery disease treatment is common. Pre-treatment work status is the strongest predictor of full-time employment post-procedure, regardless of medical versus surgical intervention.
Area of Science:
- Cardiology
- Occupational Health
- Health Services Research
Background:
- Coronary artery disease (CAD) significantly impacts patients' ability to maintain employment.
- Understanding factors influencing return to work is crucial for patient well-being and economic productivity.
Purpose of the Study:
- To assess the proportion of patients with CAD returning to full-time work after cardiac catheterization or surgery.
- To identify predictors of sustained employment in this patient population.
Main Methods:
- A registry-based study assessed patients undergoing coronary angiography, catheterization, or surgery.
- Questionnaires collected data on pre- and post-treatment work status, demographics, and clinical factors.
- Multivariate analysis was used to identify significant predictors of return to work.
Main Results:
- Pre-treatment employment rates were high (74% medical, 75% surgical).
- One year post-treatment, 62% of both medically and surgically treated patients worked full-time.
- Key predictors of return to work included prior work status, education, age, and functional class.
Conclusions:
- Work status prior to cardiac intervention is the most significant predictor of continued employment.
- Surgical therapy offers no advantage over medical therapy in maintaining full-time employment for CAD patients.
- Interventions aimed at improving return to work should consider pre-treatment employment status and patient characteristics.
Abstract:
The proportion of medically and surgically treated patients with coronary artery disease working full time 1 year after cardiac catheterization or surgery, respectively, was assessed by questionnaire in a registry of patients who had had coronary angiography. The proportion of medically and surgically treated patients working 3 months before catheterization or surgery was 74 percent (148 of 201) and 75 percent (899 of 1,198), respectively, whereas 62 percent (125 of 201) and 62 percent (747 of 1,198), respectively, were working full time 1 year after catheterization or surgery. Multivariate analysis identified five variables predictive of return to work. In order of significance these were: working status 3 months before surgery or catheterization, years of education, age, functional class before surgery or catheterization and period of not working before surgery or catheterization. Work status 3 months before surgery or catheterization was clearly the best predictor of continued employment 15 months later. Surgical therapy was not more effective than medical therapy in maintaining full-time employment in this registry of patients with coronary artery disease.