Determinants of Return to Work After Multicomponent Cardiac Rehabilitation
Related Research units
Abstract
OBJECTIVES: To explore predictors of return to work in patients after acute coronary syndrome and coronary artery bypass grafting, taking into account cognitive performance, depression, physical capacity, and self-assessment of the occupational prognosis.
DESIGN: Observational, prospective, bicentric.
SETTING: Postacute 3-week inpatient cardiac rehabilitation (CR).
PARTICIPANTS: Patients (N=401) <65 years of age (mean 54.5±6.3y), 80% men.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Status of return to work (RTW) 6 months after discharge from CR.
RESULTS: The regression model for RTW showed negative associations for depression (odds ratio 0.52 per SD, 95% confidence interval 0.36-0.76, P=.001), age (odds ratio 0.72, 95% confidence interval 0.52-1.00, P=.047), and in particular for a negative subjective occupational prognosis (expected incapacity for work odds ratio 0.19, 95% confidence interval 0.06-0.59, P=.004; unemployment odds ratio 0.08, 95% confidence interval 0.01-0.72, P=.024; retirement odds ratio 0.07, 95% confidence interval 0.01-0.067, P=.021). Positive predictors were employment before the cardiac event (odds ratio 9.66, 95% confidence interval 3.10-30.12, P<.001), capacity to work (fit vs unfit) at discharge from CR (odds ratio 3.15, 95% confidence interval 1.35-7.35, P=.008), and maximum exercise capacity (odds ratio 1.49, 95% confidence interval 1.06-2.11, P=.022). Cognitive performance had no effect.
CONCLUSIONS: The patient's perception and expectation regarding the occupational prognosis play a crucial role in predicting return to work 6 months after an acute cardiac event and CR. These findings highlight the importance of the multimodal approach, in particular psychosocial components, of CR.
Bibliographical data
Original language | English |
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ISSN | 0003-9993 |
DOIs | |
Publication status | Published - 12.2019 |
PubMed | 31054294 |
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