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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Workforce affiliation in primary and secondary prevention implantable cardioverter defibrillator patients: a
Simone H Rosenkranz1, Charlotte H Wichmand1, Lærke Smedegaard1
1Department of Cardiology, Copenhagen University Hospital, Herlev and Gentofte, Hellerup, Denmark.
Insights
Most patients receiving an implantable cardioverter defibrillator (ICD) return to work, but lower education and other factors increase the risk of not returning. This study identifies key risk markers for workforce re-entry after ICD implantation.
Area of Science:
- Cardiology
- Public Health
- Occupational Medicine
Background:
- Limited research exists on workforce affiliation post-implantable cardioverter defibrillator (ICD) implantation.
- Understanding return-to-work factors is crucial for patient well-being and healthcare system efficiency.
Purpose of the Study:
- To investigate workforce affiliation in patients undergoing first-time ICD implantation.
- To identify risk markers associated with not returning to work after ICD implantation.
Main Methods:
- Utilized nationwide Danish registers to identify working-age patients (30-65 years) with first-time ICD implantation (2007-2017).
- Employed descriptive statistics and logistic regression models to analyze workforce affiliation and risk markers.
- Stratified analyses by indication for ICD implantation (primary and secondary prevention).
Main Results:
- Of 4659 patients, 71% were in the workforce; 81% (primary prevention) and 75% (secondary prevention) of employed patients returned to work within one year.
- Risk markers for not returning to work included younger age (primary prevention), female sex, reduced ejection fraction (LVEF ≤40%), lower income, and multiple comorbidities (secondary prevention).
- Lower educational level was a significant risk marker for not returning to work in both primary and secondary prevention groups.
Conclusions:
- High proportions of patients return to work after ICD implantation, with sustained employment.
- Identified significant risk markers, notably lower educational level, impacting return-to-work rates.
- Findings highlight the need for targeted support for patients at risk of prolonged work absence.
Background And Aim:
There are a paucity of studies investigating workforce affiliation in connection with first-time implantable cardioverter defibrillator (ICD)-implantation. This study explored workforce affiliation and risk markers associated with not returning to work in patients with ICDs.
Methods:
Using the nationwide Danish registers, patients with a first-time ICD-implantation between 2007 and 2017 and of working age (30-65 years) were identified. Descriptive statistic and logistic regression models were used to describe workforce affiliation and to estimate risk markers associated with not returning to work, respectively. All analyses were stratified by indication for implantation (primary and secondary prevention).
Results:
Of the 4659 ICD-patients of working age, 3300 patients (71%) were members of the workforce (employed, on sick leave or unemployed) (primary: 1428 (43%); secondary:1872 (57%)). At baseline, 842 primary and 1477 secondary prevention ICD-patients were employed. Of those employed at baseline, 81% primary and 75% secondary prevention ICD-patients returned to work within 1 year, whereof more than 80% remained employed the following year. Among patients receiving sick leave benefits at baseline, 25% were employed after 1 year. Risk markers of not returning to work were 'younger age' in primary prevention ICD-patients, while 'female sex', left ventricular ejection fraction 'LVEF ≤40', 'lower income', and '≥3 comorbidities' were risk markers in secondary prevention ICD-patients. Lower educational level was a risk marker in both patient groups.
Conclusion:
High return-to-work proportions following ICD-implantation, with a subsequent high level of employment maintenance were found. Several significant risk markers of not returning to work were identified including 'lower educational level' that posed a risk in both patient groups.
Trial Registration Number:
Capital Region of Denmark, P-2019-051.
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