Clinical and Occupational Status of Patients with Coronary Artery Disease (CAD) who Underwent Aorto Coronary Bypass Surgery (ACBS)

Abstract

To assess the postoperative clinical and occupational status of patients with CAD who underwent ACBS we analyzed the data of 267 patients (90% male) with an average age of 48 years with a range of 30 to 55 years at the time of surgery; all of these patients had been working up to this event.The clinical data include information obtained from pre- and post-operative coronary arteriography and left ventriculography; also included is information from the surgery procedure and prior as well as postoperative symptoms. The demographic data contained information concerning the occupational status before and after surgery, reason for failure of resumption of work and patient satisfaction with the outcome of the operation; this information was collected using a standardized questionnaire on the last reexamination an average period of 25 (range 9 to 36) months after surgery. The symptomatic relief and rehabilitation was determined for each patient at the same time.On average 3.3 months after ACBS 53 % of all patients went back to work, 47% didn’t take up a professional activity within the follow up period.The 145 ‘worker’ after ACBS with an average age of 46.3 years were significantly younger than the 112 ‘non worker’ with 49.5 years (p < 0. 001).The lack of physical stress at work showed a highly significant influence on resumption of work. Whereas out of 85 white collar workers (59 employees, 18 employers and 8 civil servants) 82 % continued working after ACBS, out of 182 blue collar workers only 39 % resumed their professional activity (p < 0.001).Based on the comparable initial degree (3.4 versus 3.5) the extent of the angina symptomatic after ACBS averaged 1.2+0.5 in the ‘worker’. and 1. 5 ± 0.8 in the ‘non worker’ group, and thus the difference was significant at the 1 % level.The participation in a rehabilitation program with 91 patients in the ‘worker’ and 48 patients in the ‘non worker’ group was significantly different at the 1 % level.Whereas preoperatively both groups showed a similar value of left ventricular ejection fraction (57.6 % against 56.5 %), the postoperative value with 61.3 ± 5.6 % in the ‘non worker’ and 5 7.4 + 8.3 % in the ‘non worker’ group was significantly different at the 5 % level.We conclude that the strategy for improving resumption of work is to decrease the considerable waiting time for preoperative diagnosis and surgery; and with five objective predictive factors, it is possible to discern patients with the lowest resumption of work prognosis and to submit them to an individualized postoperative rehabilitation program.KeywordsLeft Anterior DescendAngina PectorisCivil ServantOccupational StatusRight Coronary ArteryThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.