Coronary artery bypass patients and work status

Retrospective surgery data were obtained from 358 coronary artery bypass surgery patients 4-22 months (mean 12.5 months) after surgery. Before surgery, 69% of the subjects were working, 10% were unemployed, and 21% were retired. At follow-up, only 58% were working and 29% were retired. Employment before surgery was the most significant predictor of work status after surgery. Other factors that were positively related to returning to work include higher presurgery income and job classification, higher pre- and postoperative ejection fraction, and subjective improvement in tolerance for physical activity. Factors that were negatively related to returning to work were age, number of chronic medical problems, presence of cardiac symptoms, and receipt of disability compensation. Reported improvement in symptoms was not related to postoperative work status. Job classification, physical demands of the job, and time out of work before surgery were also related to how soon patients returned to work. Participation in an outpatient rehabilitation program was significantly related to postoperative work status for men employed before surgery. Questions were raised regarding the role of outpatient cardiac rehabilitation in altering patient perceptions and maintaining "work habits" that might facilitate work resumption after coronary artery bypass surgery. The results suggest that multiple physical, social and psychological factors interact to influence postoperative work status.