Return to the workforce following coronary artery bypass grafting: A Danish nationwide cohort study

Int J Cardiol. 2018 Jan 15:251:15-21. doi: 10.1016/j.ijcard.2017.10.032. Epub 2017 Oct 16.

Abstract

Background: Returning to the workforce after coronary artery bypass grafting (CABG) holds important socioeconomic consequences not only for patients, but the society as well. Yet data on this issue are limited. We examined return to the workforce and associated factors in patients of working age undergoing CABG.

Methods and results: Using Danish nationwide administrative registries, we identified 6031 patients of working age (18-60years) undergoing isolated CABG (1998-2011) who were part of the workforce 30days prior to admission and alive at discharge. One year after discharge for CABG, 4827 (80.0%) patients had returned to the workforce, 614 (10.2%) were on paid sick leave, 267 (4.4%) received disability pension, 250 (4.1%) were on early retirement, 57 (0.9%) had died, and 16 (0.3%) had emigrated. Factors associated with return to the workforce were identified using multivariable logistic regression. Younger age (18-45 versus 56-60years; odds ratio, 1.89; 95% confidence interval, 1.48-2.42), male sex (1.51, 1.24-1.84), and higher level of education (higher educational level versus basic school; 1.53, 1.05-2.23) and income (highest quartile versus lowest; 3.01, 2.42-3.75) were associated with return to the workforce. Urgency of surgery (emergency versus elective; 0.65, 0.49-0.88), cardiovascular comorbidity, a history of chronic kidney disease (0.49, 0.29-0.84) and liver disease (0.47, 0.28-0.80), as well as additional hospital admissions within the first year post-discharge (>2 versus none; 0.25, 0.19-0.32) were associated with a lower likelihood of returning to the workforce.

Conclusion: One year after discharge for CABG, four out of five patients were part of the workforce and mortality was low. Younger age, male sex, higher socioeconomic status, and absence of major comorbidities were associated with return to the workforce.

Keywords: Coronary artery bypass grafting; Coronary artery disease; Epidemiology; Workforce attachment.

MeSH terms

  • Adolescent
  • Adult
  • Cohort Studies
  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Bypass / trends*
  • Coronary Artery Disease / epidemiology*
  • Coronary Artery Disease / surgery*
  • Denmark / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Patient Discharge / trends
  • Registries
  • Retrospective Studies
  • Return to Work / trends*
  • Risk Factors
  • Sick Leave / trends*
  • Young Adult