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急性心肌梗死后重返工作岗位:年轻女性与男性的比较

Return to Work After Acute Myocardial Infarction: Comparison Between Young Women and Men.

作者信息

Dreyer Rachel P, Xu Xiao, Zhang Weiwei, Du Xue, Strait Kelly M, Bierlein Maggie, Bucholz Emily M, Geda Mary, Fox James, D'Onofrio Gail, Lichtman Judith H, Bueno Héctor, Spertus John A, Krumholz Harlan M

机构信息

From the Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D., X.X., W.Z., K.M.S., M.B., E.M.B., M.G., J.H.L., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (R.P.D., H.M.K.), Department of Obstetrics, Gynecology, and Reproductive Sciences (X.X.), Department of Emergency Medicine (G.D.), and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (H.M.K.), Yale School of Medicine, New Haven, CT; National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China (X.D.); Munson Medical Center, Traverse City, MI (J.F.); Department of Chronic Disease Epidemiology (J.H.L.) and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Instituto de Investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre; Universidad Complutense de Madrid, Madrid, Spain (H.B.); University of Missouri - Kansas City, School of Medicine, Biomedical & Health Informatics (J.A.S.); and Saint Luke's Mid America Heart Institute, Kansas City, MO (J.A.S.)

From the Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D., X.X., W.Z., K.M.S., M.B., E.M.B., M.G., J.H.L., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (R.P.D., H.M.K.), Department of Obstetrics, Gynecology, and Reproductive Sciences (X.X.), Department of Emergency Medicine (G.D.), and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (H.M.K.), Yale School of Medicine, New Haven, CT; National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China (X.D.); Munson Medical Center, Traverse City, MI (J.F.); Department of Chronic Disease Epidemiology (J.H.L.) and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Instituto de Investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre; Universidad Complutense de Madrid, Madrid, Spain (H.B.); University of Missouri - Kansas City, School of Medicine, Biomedical & Health Informatics (J.A.S.); and Saint Luke's Mid America Heart Institute, Kansas City, MO (J.A.S.).

出版信息

Circ Cardiovasc Qual Outcomes. 2016 Feb;9(2 Suppl 1):S45-52. doi: 10.1161/CIRCOUTCOMES.115.002611.

Abstract

BACKGROUND

Return to work after acute myocardial infarction (AMI) is an important outcome and is particularly relevant to young patients. Women may be at a greater risk for not returning to work given evidence of their worse recovery after AMI than similarly aged men. However, sex differences in return to work after AMI has not been studied extensively in a young population (≤ 55 years).

METHODS AND RESULTS

We analyzed data from 1680 patients with AMI aged 18 to 55 years (57% women) participating in the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) study who were working full time (≥ 35 hours) before the event. Data were obtained by medical record abstraction and patient interviews. We conducted multivariable regression analyses to examine sex differences in return to work at 12 months after AMI, and the association of patient characteristics with return to work. When compared with young men, young women were less likely to return to work (89% versus 85%; 85% versus 89%, P=0.02); however, this sex difference was not significant after adjusting for patient sociodemographic characteristics, psychosocial factors, and health measures. Being married, engaging in a professional or clerical type of work, having more favorable physical health, and having no previous coronary disease or hypertension were significantly associated with a higher likelihood of return to work at 12 months.

CONCLUSIONS

Among a young population, women are less likely to return to work after AMI than men. This disadvantage is explained by differences in demographic, occupational, and health characteristics.

摘要

背景

急性心肌梗死(AMI)后重返工作岗位是一项重要的结果,对年轻患者尤为重要。有证据表明,与年龄相仿的男性相比,女性在AMI后恢复较差,因此她们可能面临更大的无法重返工作岗位的风险。然而,在年轻人群(≤55岁)中,AMI后重返工作岗位的性别差异尚未得到广泛研究。

方法与结果

我们分析了参与“恢复差异:性别对年轻AMI患者结局的影响(VIRGO)”研究的1680例年龄在18至55岁之间的AMI患者(57%为女性)的数据,这些患者在事件发生前全职工作(≥35小时)。数据通过病历摘要和患者访谈获得。我们进行了多变量回归分析,以检验AMI后12个月重返工作岗位的性别差异,以及患者特征与重返工作岗位的关联。与年轻男性相比,年轻女性重返工作岗位的可能性较小(89%对85%;85%对89%,P=0.02);然而,在调整患者社会人口学特征、心理社会因素和健康指标后,这种性别差异并不显著。已婚、从事专业或文职类工作、身体健康状况较好、既往无冠心病或高血压与12个月时更高的重返工作岗位可能性显著相关。

结论

在年轻人群中,AMI后女性比男性重返工作岗位的可能性更小。这种劣势可以通过人口统计学、职业和健康特征的差异来解释。

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