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影响慢性冠状动脉综合征患者重返工作岗位的因素:一项前瞻性研究。

Factors Affecting Return to Work of Patients with Chronic Coronary Syndrome: A Prospective Study.

作者信息

Oancea Corina, Gherman Despina Mihaela, Capraru Rodica Simona, Aurelian Sorina Maria, Nedelescu Mirela Maria, Popescu Florina Georgeta

机构信息

Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.

The National Institute for Medical Assessment and Work Capacity Rehabilitation, 050659 Bucharest, Romania.

出版信息

Healthcare (Basel). 2025 Sep 20;13(18):2368. doi: 10.3390/healthcare13182368.

Abstract

: Return to work is an important goal of cardiac rehabilitation, yet individuals recovering from cardiovascular disease often face significant challenges in achieving it. As a result, a significant proportion of individuals with coronary artery disease experience work disability, negatively impacting both their economic well-being and quality of life while imposing a substantial financial burden on society. This less-studied issue is often treated as a secondary outcome in research, resulting in return to work findings that are frequently underreported. As such, this study aimed to identify the factors associated with adequate levels of functional capacity enabling the engagement in professional work and to develop a model for predicting the potential return to work of patients with coronary artery disease. During 2024, we enrolled 250 consecutive patients with chronic coronary syndrome less than 65 years of age who were referred to the National Institute for Medical Assessment and Work Capacity Rehabilitation (INEMRCM) for medical evaluation to establish eligibility-to-work disability benefits. Patients underwent a revascularization procedure either using PTCA or CABG, with a few having had no revascularization until the moment of assessment. Detailed demographic, socioeconomic, and clinical data were collected via interviews. Logistic regression was used to develop a multivariable model for predicting return to work. Six months after discharge from the INEMRCM, around 20% of participants had returned to work. A better functional status was determinant for individuals' re-employment ( = 0.026) along with an absence of cardiovascular comorbidities ( = 0.045) and holding a higher-skilled occupation ( = 0.037). The multivariate analysis identified professional specialization and the absence of cardiovascular comorbidities as the strongest predictors of return to work. Cardiac patients with coexisting cardiovascular conditions engaged in less-specialized types of work tend to experience poorer return to work outcomes. As such, individuals in this category should be carefully assessed and prioritized in the development of targeted rehabilitation programs.

摘要

重返工作岗位是心脏康复的一个重要目标,但从心血管疾病中康复的个体在实现这一目标时往往面临重大挑战。因此,相当一部分冠心病患者存在工作能力丧失的情况,这对他们的经济状况和生活质量都产生了负面影响,同时也给社会带来了巨大的经济负担。这个较少被研究的问题在研究中往往被视为次要结果,导致重返工作岗位的研究结果经常未得到充分报道。因此,本研究旨在确定与具备足够功能能力以从事专业工作相关的因素,并建立一个模型来预测冠心病患者潜在的重返工作岗位情况。在2024年期间,我们连续招募了250名年龄小于65岁的慢性冠状动脉综合征患者,他们被转介到国家医学评估和工作能力康复研究所(INEMRCM)进行医学评估,以确定其是否符合领取工作能力丧失福利的条件。患者接受了经皮冠状动脉腔内血管成形术(PTCA)或冠状动脉旁路移植术(CABG)的血管重建手术,少数患者在评估时还未进行血管重建手术。通过访谈收集了详细的人口统计学、社会经济和临床数据。使用逻辑回归建立了一个多变量模型来预测重返工作岗位情况。从INEMRCM出院六个月后,约20%的参与者已重返工作岗位。更好的功能状态(P = 0.026)、无心血管合并症(P = 0.045)以及从事技能要求较高的职业(P = 0.037)是个体重新就业的决定性因素。多变量分析确定专业领域和无心血管合并症是重返工作岗位的最强预测因素。患有心血管合并症且从事专业性较低工作类型的心脏病患者往往重返工作岗位的结果较差。因此,对于这一类个体,在制定针对性的康复计划时应进行仔细评估并给予优先考虑。

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