Sadeghi Masoumeh, Saririyan Maryam, Kermani-Alghoraishi Mohammad, Ghahramani Rahil, Jamalian Marjan, Roohafza Hamidreza, Soleimani Nazanin
Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Medicine (Baltimore). 2025 Apr 11;104(15):e41839. doi: 10.1097/MD.0000000000041839.
This study aimed to evaluate return to work (RTW) across different job groups, identify predictors of successful RTW, and investigate reasons for RTW failure. This case-control study, conducted in 2022, included 164 male patients who had ST elevation myocardial infarction (STEMI) in 2016 to 2017 and were registered in the 5-year ST Elevation Myocardial Infarction Cohort in Isfahan, Iran. Patients were divided into RTW (n = 82) and RTW failure (n = 82) groups, frequency-matched for education, marital status, and comorbidities. Baseline data were extracted from the cohort database, and occupational factors were gathered via telephone contact. Statistical analysis was performed using chi-square tests, t tests, and multivariate logistic regression to identify significant predictors of RTW, with P < .05 considered statistically significant. Data from 164 patients aged 18 to 65 with STEMI showed that those who returned to work had a mean age of 49.05 years, compared to 53.04 years for those who did not (P = .001). Factors associated with increased RTW included younger age (odds ratios [OR]: 0.86; 95% confidence intervals: 0.77-0.95), shorter hospitalization (OR: 0.63; 0.44-0.91), and lower first systolic blood pressure (OR: 0.97; 0.94-0.99). Most patients (49.39%, n = 59) returned within 1 month. Common RTW failure reasons were personal decisions (36.58%, n = 30), retirement (25.61%, n = 21), and choosing lighter jobs (25.61%, n = 21). No significant relationship was found between job groups of the International Standard Classification of Occupations and RTW (P = .581). Our study identifies key factors influencing RTW after STEMI, including age, history of myocardial infarction, hospitalization duration, treatment methods, and initial systolic blood pressure. The most common barrier to RTW was patient unwillingness. A comprehensive approach that integrates primary prevention, personalized rehabilitation, and financial and social support is recommended to improve RTW outcomes.
本研究旨在评估不同工作群体的重返工作岗位（RTW）情况，确定成功重返工作岗位的预测因素，并调查重返工作岗位失败的原因。这项病例对照研究于2022年进行，纳入了164名在2016年至2017年期间发生ST段抬高型心肌梗死（STEMI）且登记在伊朗伊斯法罕5年ST段抬高型心肌梗死队列中的男性患者。患者被分为重返工作岗位组（n = 82）和重返工作岗位失败组（n = 82），根据教育程度、婚姻状况和合并症进行频率匹配。基线数据从队列数据库中提取，职业因素通过电话联系收集。使用卡方检验、t检验和多因素逻辑回归进行统计分析，以确定重返工作岗位的显著预测因素，P <.05被认为具有统计学意义。164名年龄在18至65岁之间的STEMI患者的数据显示，重返工作岗位的患者平均年龄为49.05岁，未重返工作岗位的患者平均年龄为53.04岁（P =.001）。与重返工作岗位增加相关的因素包括年龄较小（比值比[OR]：0.86；95%置信区间：0.77 - 0.95）、住院时间较短（OR：0.63；0.44 - 0.91）和首次收缩压较低（OR：0.97；0.94 - 0.99）。大多数患者（49.39%，n = 59）在1个月内重返工作岗位。重返工作岗位失败的常见原因是个人决定（36.58%，n = 30）、退休（25.61%，n = 21）和选择较轻的工作（25.61%，n = 21）。国际职业标准分类的工作群体与重返工作岗位之间未发现显著关系（P =.581）。我们的研究确定了影响STEMI后重返工作岗位的关键因素，包括年龄、心肌梗死病史、住院时间、治疗方法和首次收缩压。重返工作岗位最常见的障碍是患者不愿意。建议采用综合方法，包括一级预防、个性化康复以及经济和社会支持，以改善重返工作岗位的结果。
