Hlatky M A, Boothroyd D, Horine S, Winston C, Brooks M M, Rogers W, Pitt B, Reeder G, Ryan T, Smith H, Whitlow P, Wiens R, Mark D B
Stanford University School of Medicine, California 94305-5405, USA.
Ann Intern Med. 1998 Oct 1;129(7):543-7. doi: 10.7326/0003-4819-129-7-199810010-00006.
Patients who undergo coronary angioplasty have a shorter convalescence than those who undergo coronary bypass surgery. This may improve subsequent employment.
To compare employment patterns after coronary angioplasty or surgery.
Multicenter, randomized clinical trial.
Seven tertiary care hospitals.
409 employed patients with multivessel coronary artery disease.
Coronary bypass surgery or balloon angioplasty.
Time to return to work and time spent working during 4 years of follow-up.
Patients who underwent angioplasty returned to work 6 weeks sooner than patients who underwent coronary bypass surgery (P < 0.001), but long-term employment did not differ significantly (P > 0.2). Long-term employment was significantly lower among patients who were 60 to 64 years of age (P < 0.001), those who worked less than full-time at study entry (P < 0.001), and those who had less formal education (P = 0.005). Patients with only one source of health insurance were more likely to continue working (P = 0.005).
Faster recovery after angioplasty speeds return to work but does not improve long-term employment, which is primarily associated with nonmedical factors.
接受冠状动脉血管成形术的患者恢复期比接受冠状动脉搭桥手术的患者短。这可能会改善后续的就业情况。
比较冠状动脉血管成形术或手术后的就业模式。
多中心随机临床试验。
七家三级护理医院。
409名患有多支冠状动脉疾病的在职患者。
冠状动脉搭桥手术或球囊血管成形术。
随访4年期间的重返工作时间和工作时长。
接受血管成形术的患者比接受冠状动脉搭桥手术的患者早6周重返工作岗位（P<0.001），但长期就业情况无显著差异（P>0.2）。60至64岁的患者、研究开始时非全职工作的患者以及正规教育程度较低的患者长期就业率显著较低（P<0.001、P<0.001、P = 0.005）。只有一种医疗保险来源的患者更有可能继续工作（P = 0.005）。
血管成形术后恢复较快能加快重返工作岗位的速度，但并不能改善长期就业情况，长期就业情况主要与非医疗因素相关。
