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Factors Associated with Return to Work After Heart Transplantation: A Systematic Review of the Literature
Edilma L Rivera1, Julián Aponte2, Maria C Montes3
1Master of Occupational Health Program, Health Sciences Department, Universidad Libre, Cali, Columbia USA; Cardiology Service, Department of Internal Medicine, Fundación Valle del Lili, Cali, Columbia USA.
Insights
Return to work after heart transplantation is often low, especially for older patients. Higher education, younger age, and better physical/mental health are key factors for successful return to work.
Area of Science:
- Cardiology
- Transplantation Medicine
- Occupational Health
Background:
- Heart transplantation is a critical treatment for advanced heart failure.
- Factors influencing return to work post-heart transplant are not well understood.
Purpose of the Study:
- To identify factors associated with return to work in heart transplant recipients.
Main Methods:
- Systematic literature review of PubMed, LILACS, SCIELO, and ScienceDirect databases.
- Included quantitative studies on adult heart transplant patients published between 2007-2017.
Main Results:
- 6 studies were included; 30-60% of patients returned to work.
- Positive factors: higher education, younger age, better SF-36 scores, improved 6-minute walk test, and shorter prior work interruption.
- Return to work averaged 6-7.5 months post-transplant.
Conclusions:
- Return to work rates post-heart transplant are variable and generally low.
- Older age nearing retirement is associated with lower return-to-work rates.
- Social, physical, and mental well-being are protective factors for returning to work.
Background:
Heart transplantation represents one of the last treatment options for advanced heart failure. Little is known about the factors associated with return to work in patients after heart transplantation. The aim of this study was to identify those factors.
Methods:
A systematic literature review was conducted in the PubMed, LILACS, SCIELO and ScienceDirect databases using the keywords "trasplante cardiaco", "calidad de vida", "reingreso laboral", "return to work", "heart transplantation" and "occupation related". Quantitative studies with patients over 18 years of age that were published between January 2007 and June 2017 were included.
Results:
A total of 6 articles were included, none from Latin America. Heart transplantation patients had a mean age of 51 years; approximately 17% were over 65 years of age; 73-84% were males; 7-16.4% were professionals; 70-86.6% were previously employed; and 30-60% returned to work. The following factors were related to return to work: higher education (p = 0.0017), young age (p = 0.003), better scores on the physical and mental domains of the SF-36 questionnaire (p = 0.035), higher six-minute walk test results (median of 560 m), and previous employment with less than 24 months interrupted by the inability to work (p = 0.017). Return to work occurred, on average, 6 to 7.5 months after heart transplantation.
Conclusions:
Return to work after heart transplantation is variable, with a tendency to be low, and is lower in patients near to retirement age. Protective factors were related to the social, physical and mental environment.
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