The rehabilitation of coronary surgical patients.

Coronary revascularization has been reported to have failed to effectively rehabilitate working-age patients. This study of 565 patients demonstrates that motivation to return to work is strongly influences by age and educational level. Patients under age 55 are more likely to return to work than are patients over that age, but preoperative job classification does not influence rehabilitation. Although preoperative disability was associated with a slightly lower return-to-work rate (90%) than was the case with patients working preoperatively (97%) preoperative retirement was a strongly negative influence on rehabilitation. In this study, 80% of the patients worked to or beyond retirement age, and duration of work was not influenced by preoperative disability. The salary produced by those patients who were rehabilitated by surgery was four and a half times greater than the total cost of care and disability payments for the entire patient population. The factors which seemed to be the most important in effective rehabilitation were the psychological preparation of patients and their families and the attitude toward rehabilitation expressed by physicians and employers.