Monpère C, Rajoelina A, Vernochet P, Mirguet C, Thebaud N
Centre de réadaptation cardiovasculaire Bois Gibert, Ballan Mire.
Arch Mal Coeur Vaiss. 2000 Jul;93(7):797-806.
This was a prospective study of the modalities of return to work in a male population of 128 patients (mean age 48.9 years)) admitted for cardiovascular rehabilitation after acute infarction or coronary bypass surgery and followed up for 7 years. At one year, 78.9% of the population had returned to work (average delay 126 +/- 97 days), usually to the same job (66.3%) after adaptation (25.8%) or professional reconversion (7.9%). After 3 and 7 years follow-up, the active population was 62.5% and 40.7% respectively and the main reason for definite stopping work was retirement (63%). Temporary stoppages were short (4.5 days and 8.2 days per patient per year at 3 and 7 years respectively), illustrating the good quality of professional rehabilitation. The factors influencing return to work during the first age were young age (47.5 versus 52.7 years) and negative exercise stress tests (83% versus 59% in cases of positive tests, p < 0.05). This study and a review of the literature were used to undertake a medico-economic analysis which showed decreased economic consequences in patients referred for rehabilitation: over 5 years in a group of 100 patients, an economy of 5,818 KF after myocardial infarction or 2,677 KF after coronary bypass surgery was demonstrated. The reasons for these economies were the reduced direct (hospital admissions) and indirect costs (social security reimbursement for off-work and invalidity pensions). Those favourable results underline the value of a consultation of professional aptitude in all programmes of cardiovascular rehabilitation.
这是一项针对128名男性患者(平均年龄48.9岁)的前瞻性研究,这些患者因急性心肌梗死或冠状动脉搭桥手术后接受心血管康复治疗,并进行了7年的随访。一年后,78.9%的患者恢复工作(平均延迟126±97天),通常是回到原工作岗位(66.3%),经过适应(25.8%)或职业转换(7.9%)。在3年和7年随访后,在职人口分别为62.5%和40.7%,确定停止工作的主要原因是退休(63%)。临时停工时间较短(3年和7年时分别为每位患者每年4.5天和8.2天),这说明职业康复质量良好。影响首次康复期间恢复工作的因素是年轻(47.5岁对52.7岁)和运动应激试验阴性(阳性试验病例中分别为83%对59%,p<0.05)。本研究及文献综述用于进行医学经济分析,结果显示接受康复治疗的患者经济后果降低:在一组100名患者中,5年期间,心肌梗死后节省5818法郎,冠状动脉搭桥手术后节省2677法郎。这些节省的原因是直接费用(住院)和间接费用(失业社会保障报销和残疾抚恤金)减少。这些良好结果强调了在所有心血管康复计划中进行职业能力咨询的价值。