Permanent work disability in patients ≤50 years old after percutaneous coronary intervention and coronary artery bypass grafting (the CRAGS study)
Lautamäki, Anna; Gunn, Jarmo M.; Airaksinen, Kari Eino Juhani; Biancari, Fausto; Kajander, Olli A.; Anttila, Vesa; Heikkinen, Jouni; Eskola, Markku; Ilveskoski, Erkki; Mennander, Ari; Korpilahti, Kari; Wistbacka, Jan-Ola; Kiviniemi, Tuomas O. (2016-08-24)
Anna Lautamäki, Jarmo M. Gunn, Kari Eino Juhani Airaksinen, Fausto Biancari, Olli A. Kajander, Vesa Anttila, Jouni Heikkinen, Markku Eskola, Erkki Ilveskoski, Ari Mennander, Kari Korpilahti, Jan-Ola Wistbacka, Tuomas O. Kiviniemi, Permanent work disability in patients ≤50 years old after percutaneous coronary intervention and coronary artery bypass grafting (the CRAGS study), European Heart Journal - Quality of Care and Clinical Outcomes, Volume 3, Issue 2, April 2017, Pages 101–106, https://doi.org/10.1093/ehjqcco/qcw043
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. This is a pre-copyedited, author-produced version of an article accepted for publication in European Heart Journal - Quality of Care and Clinical Outcomes following peer review. The version of record [insert complete citation information here] is available online at: https://doi.org/10.1093/ehjqcco/qcw043.
https://rightsstatements.org/vocab/InC/1.0/
https://urn.fi/URN:NBN:fi-fe2019102134012
Tiivistelmä
Abstract
Background: The aim of this study was to investigate the incidence of permanent working disability (PWD) in young patients after percutaneous or surgical coronary revascularization.
Methods and Results: The study included 1035 consecutive patients ≤50 years old who underwent coronary revascularization [910 and 125 patients in percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) groups, respectively] between 2002 and 2012 at 4 Finnish hospitals. The median follow-up time was 41 months. The overall incidence of PWD was higher after CABG compared to PCI (at 5 years, 34.8 vs. 14.7%, P < 0.001). Freedom from PWD in the general population aged 45 was 97.2% at 4 years follow-up. Median time to grant disability pension was 11.6 months after CABG and 24.4 months after PCI (P = 0.018). Reasons for PWD were classified as cardiac (35.3 vs. 36.9%), psychiatric (14.7 vs. 14.6%), and musculoskeletal (14.7 vs. 15.5%) in patients undergoing CABG vs. PCI. Overall freedom from PWD was higher in patients without major adverse cardiac and cerebrovascular event (MACCE) (at 5 years, 85.6 vs. 71.9%, P < 0.001). Nevertheless, rate of PWD was high also in patients without MACCE and patients with preserved ejection fraction during follow-up.
Conclusions: Although coronary revascularization confers good overall survival in young patients, PWD is common especially after CABG and mostly for cardiac reasons even without occurrence of MACCE. Supportive measures to preserve occupational health are warranted concomitantly with coronary revascularization at all levels of health care.
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