Work-related outcome after acute coronary syndrome: Implications of complex cardiac rehabilitation in occupational medicine

• Main Authors: Monica Lamberti, Gennaro Ratti, Donato Gerardi, Cristina Capogrosso, Gianfranco Ricciardi, Cosimo Fulgione, Salvatore Latte, Paolo Tammaro, Gregorio Covino, Albert Nienhaus, Elpidio Maria Garzillo, Mario Mallardo, Paolo Capogrosso
• Format: Article
• Language: English
• Published: Nofer Institute of Occupational Medicine 2016-08-01
• Series: International Journal of Occupational Medicine and Environmental Health
• Subjects: depression; rehabilitation; workers; acute coronary syndrome; counseling; anxiety
• Online Access: http://ijomeh.eu/Work-related-outcome-after-acute-coronary-syndrome-Implications-of-complex-cardiac-nrehabilitation-in-occupational-medicine,58985,0,2.html
• ISSN: 1232-1087; 1896-494X

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.