Predicting return to work after acute myocardial infarction: Socio-occupational factors overcome clinical conditions

• Published in: PloS one Vol. 13; no. 12; p. e0208842
• Main Authors: Stendardo, Mariarita, Bonci, Melissa, Casillo, Valeria, Miglio, Rossella, Giovannini, Giulia, Nardini, Marco, Campo, Gianluca, Fucili, Alessandro, Boschetto, Piera
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 13.12.2018; Public Library of Science (PLoS)
• Subjects: Acute coronary syndromes; Adult; Analysis; Angioplasty; Angioplasty, Balloon, Coronary; Anxiety; Balloon angioplasty; Biology and Life Sciences; Cardiac patients; Cardiology; Cardiovascular disease; Care and treatment; Coronary angiography; Coronary vessels; Death; Depression (Mood disorder); Depression - psychology; Education; Employment; Female; Health aspects; Heart attack; Heart attacks; Heart surgery; Hospitals; Humans; Male; Medical prognosis; Medical research; Medicine and Health Sciences; Mental depression; Middle Aged; Mortality; Multivariate analysis; Myocardial infarction; Myocardial Infarction - surgery; Patients; Physical therapy; Rehabilitation; Return to Work; Self employment; Sick Leave; Social factors; Social Sciences; Sociodemographics; Socioeconomic Factors; Spirometry; Time Factors; Universities and colleges; Workers; Workplace accommodation; New York; United States > US; Italy
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0208842

Return to work after acute myocardial infarction (AMI), a leading cause of death globally, is a multidimensional process influenced by clinical, psychological, social and occupational factors, the single impact of which, however, is still not well defined. The objective of this study was to investigate these 4 factors on return to work (RTW) within 365 days after AMI in a homogeneous cohort of patients who had undergone an urgent coronary angioplasty. We studied 102 patients, in employment at the time of AMI (88.24% of men), admitted to the Department of Cardiology of the University-Hospital of Ferrara between March 2015 to December 2016. Demographical and clinical characteristics were obtained from the cardiological records. After completing an interview on social and occupational variables and the Hospital Anxiety and Depression (HADS) questionnaire, patients underwent exercise capacity measurement and spirometry. Of the 102 patients, only 12 (12.76%) held a university degree, 68.63% were employees and 31.37% self-employed. The median number of sick-leave days was 44 (IQR 33-88). At day 30, 78.5% of all subjects had not returned to work, at day 60, 40.8% and at day 365 only 7.3% had not resumed working. At univariate analyses, educational degree (p = 0.026), self-employment status (p = 0.0005), white collar professional category (p = 0.020) and HADS depression score were significant for earlier return to work. The multivariate analysis confirms that having a university degree, being self-employed and presenting a lower value of HADS depression score increase the probability of a quicker return to work. These findings suggest that the strongest predictors of returning to work within 1 year after discharge for an acute myocardial infarction are related more to socio-occupational than to clinical parameters.