ORIGINAL PAPER
Work-related outcome after acute coronary syndrome: Implications of complex cardiac
rehabilitation in occupational medicine
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1 |
Second University of Naples, Naples, Italy
(Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, School of Medicine) |
2 |
S. Giovanni Bosco Hospital, Naples 1 Local Health Unit, Naples, Italy
(Cardiology/Intensive Care Unit) |
3 |
S. Gennaro Hospital, Naples 1 Local Health Unit, Naples, Italy
(Cardiology/Cardiac Rehabilitation) |
4 |
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Institute for Health Services Research in Dermatology and Nursing) |
5 |
Institution for Statutory Accident Insurance and Welfare Services, Hamburg, Germany
(Department of Occupational Health Research) |
CORRESPONDING AUTHOR
Monica Lamberti
Second University of Naples, Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic
Medicine, School of Medicine, De Crecchio 13, 80100 Naples, Italy
Int J Occup Med Environ Health 2016;29(4):649–657
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ABSTRACT
Objectives: Coronary heart disease is frequent in the working-age population. Traditional outcomes, such as mortality and
hospital readmission, are useful for evaluating prognosis. Fit-for-work is an emerging outcome with clinical as well as socioeconomic
significance. We describe the possible benefit of a cardiac rehabilitation (CR) program for return to work (RTW)
after acute coronary syndrome (ACS). Material and Methods: We evaluated 204 patients with recent ACS. They were
divided into 4 groups on the basis of their occupational work load: very light (VL), light (L), moderate (M), and heavy (H).
Work-related outcomes were assessed with the Work Performance Scale (WPS) of the Functional Status Questionnaire
and as “days missed from work” (DMW) in the previous 4 weeks. The variables considered for outcomes were percent
ejection fraction, functional capacity expressed in metabolic equivalents (METs), and participation or non-participation in
the CR program (CR+ and CR–). Results: One hundred thirty (66%) patients took part in the CR program. Total WPS
scores for CR+ and CR– subgroups were VL group: 18±4 vs. 14±4 (p < 0.001), L group: 18±3 vs. 14±3 (p < 0.0001),
M group: 19±3 vs. 16±3 (p < 0.003), and H group: 20±4 vs. 17±3 (p < 0.006). Fewer DMW were reported by the CR+
group. Conclusions: Non-participation in CR was a consistent cause of poorer work-related outcomes. Our findings indicate
that CR and occupational counseling play a very important role in worker recovery and subsequent reintegration in
the workplace, in particular among clerical workers.