Mehrdad Ramin, Ghadiri Asli Noroja, Pouryaghoub Gholamreza, Saraei Maryam, Salimi Firoozeh, Nejatian Mostafa
Tehran University of Medical Sciences, Tehran, Iran (School of Medicine, Department of Occupational Medicine, Centre for Research on Occupational Diseases).
Tehran University of Medical Sciences, Tehran, Iran (Tehran Heart Center, Department of Cardiac Rehabilitation).
Int J Occup Med Environ Health. 2016 Nov 18;29(6):947-957. doi: 10.13075/ijomeh.1896.00798. Epub 2016 Nov 3.
Identifying factors predictive of early return to work in patients who underwent a coronary artery bypass graft surgery (CABG).
Two hundred twenty-six working patients who volunteered and underwent a primary coronary artery bypass surgery between September 2013 and May 2014 were selected for the study and followed up for 6 months. Predictors of early return to work (RTW) (within 2 months) were analyzed from variables in a prospectively collected database and the 36-Item Short Form Health Survey (SF-36) questionnaire carried out in the hospital and rehabilitation center as well as from the follow-up performed via the phone.
One hundred and two (45.1%) and 155 (68.9%) patients returned to work within 2 and 3 months after the surgery, respectively. Furthermore, 196 patients (87.1%) returned to work within 6 months after the surgery. In the univariate analysis, demographic or socioeconomic factors (such as age, level of education, income), occupational factors (such as occupation type, working hours per week, duration of the preoperative absence from work), psychological factors (such as a patient's concern about adverse health effects of RTW, feeling depressed, a patient's attitude towards his/her ability to RTW and a patient's perception of his/her job stress level) and medical factors (such as serum troponin T and creatine kinase MB (CKMB) level, pump time in surgery, co-surgery and dyslipidemia history) had a statistically significant correlation with early return to work. The patients who early returned to work had significantly higher scores in 3 domains on the SF-36 questionnaire (used for assessing the patients' quality of life), compared to those who did not return to work early (including physical functioning, role limitations due to physical health and pain).
In the present study we identified 4 new medical factors that could be used as predictors of early return to work after CABG. These factors are: normal serum troponin T level, shorter pump time in surgery, normal mean arterial pressure (MAP) before the surgery and higher serum magnesium (Mg) levels. Int J Occup Med Environ Health 2016;29(6):947-957.
确定冠状动脉旁路移植术（CABG）患者早期恢复工作的预测因素。
选取2013年9月至2014年5月间自愿接受初次冠状动脉旁路手术的226名在职患者进行研究，并随访6个月。从前瞻性收集的数据库中的变量、在医院和康复中心进行的36项简短健康调查（SF - 36）问卷以及通过电话进行的随访中分析早期恢复工作（RTW）（2个月内）的预测因素。
分别有102名（45.1%）和155名（68.9%）患者在术后2个月和3个月内恢复工作。此外，196名患者（87.1%）在术后6个月内恢复工作。在单因素分析中，人口统计学或社会经济因素（如年龄、教育程度、收入）、职业因素（如职业类型、每周工作时间、术前缺勤时间）、心理因素（如患者对恢复工作的健康不良影响的担忧、感到沮丧、患者对自己恢复工作能力的态度以及患者对工作压力水平的认知）和医学因素（如血清肌钙蛋白T和肌酸激酶MB（CKMB）水平、手术中的体外循环时间、联合手术和血脂异常病史）与早期恢复工作有统计学显著相关性。与未早期恢复工作的患者相比，早期恢复工作的患者在SF - 36问卷（用于评估患者生活质量）的3个领域得分显著更高（包括身体功能、因身体健康导致的角色限制和疼痛）。
在本研究中，我们确定了4个新的医学因素，可作为冠状动脉旁路移植术后早期恢复工作的预测因素。这些因素是：血清肌钙蛋白T水平正常、手术中的体外循环时间较短、术前平均动脉压（MAP）正常以及血清镁（Mg）水平较高。《国际职业医学与环境卫生杂志》2016年；29（6）：947 - 957。
