Evolución del impacto de la cardiopatía isquémica en la reincorporación laboral de trabajadores españoles

Abstract

espanolIntroduccion: La cardiopatia isquemica es una de las principales causas de morbimortalidad en los paises desarrollados dificultando la vuelta al trabajo de estos pacientes. Pretendemos estudiar la evolucion de la incapacidad Temporal y Permanente en trabajadores espanoles que causan baja por cardiopatia isquemica, asi como analizar las variables que influyen en la reincorporacion laboral. Material y metodos: Estudio observacional retrospectivo de cohortes con pacientes menores 65 anos que sufrieron un infarto agudo de miocardio (IAM) entre Enero de 2000 y mayo de 2011. Se recogieron datos clinicos, demograficos, socioeconomicos y laborales para analizar su relacion con la reincorporacion laboral. Resultados: Se seleccionaron un total de 5067 pacientes, el 94% varones, y con una edad media de 54,3 anos. Un total de 3.679 pacientes (72,6%) se reincorporaron a su actividad laboral tras el infarto, mientras que 1261 (24,9%) obtuvieron la incapacidad laboral permanente. La mayores tasas de incapacidad laboral se observan en los pacientes > 50 anos, en los que han sufrido un mayor dano cardiaco (FEVI 50%) y el procedimiento de revascularizacion empleado (percutaneo/cirugia) asi como las variables socioeconomicas referentes al tipo de trabajo (autonomo/cuenta ajena), ocupacion profesional (carga fisica/carga intelectual) y la edad del trabajador EnglishBackground: Ischemic cardiopathy is one of the main causes of morbidity and mortality in developed countries. It affects the patients quality of life and interferes with their return to work, thus generating a significant economic cost. The aim of our study is to assess labor conditions of patients who suffered an acute myocardial infarction (AMI), highlighting the factors that could have an impact on their return-to-work time. Materials and methods: Observational retrospective study with patients under 65 years old who suffered an AMI between January 2000 and May 2011. Data concerning clinical, social, demographic and labor circumstances was collected to better understand its relation with the return to work. Results: A total of 5.067 patients with Coronary Heart Disease (hereinafter referred to as CHD) were selected. 94% of the samples were men, under 54.3 years old. 3679 out of 5067 patients (72. 6%) returned to work after a heart infarct whereas 1261 (24.9%) did not return, obtaining the permanent incapacity to work. Among the clinical and patient factors, the main determinants were age (mostly 50% / EF >50%) and revascularization procedures (percutaneous coronary interventions -PCI- and coronary artery bypass graft surgery, CABG). Regarding the economic and job-related factors three variables were found to be the strongest predictors of returning to work: job demands (physically demanding jobs vs. intellectually demanding jobs), incomes and job conditions (self-employment vs. employees). There were no significant differences on the returning-to-work rate between men or women or between sick leave due to an acute coronary syndrome or due to an angina. We observed that the return-to-work activity increased gradually from 2000-2011 (from rates of 60% in 2000-2002 to over 80% in 2010). This increase is present in all occupational activities as well as in all age ranges. Conclusion: In our study we observed a gradual increase of patients returning to work in recent years. The variables used to better predict the return-to-work time in a period of sick leave after a CHD episode are categorized as follows: clinic viable like the extent of myocardial damage (LVEF 50%) and the revascularization procedures (Percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery, CABG), socioeconomic variables related to the kind of job (self-employment vs. employees) and lastly labor conditions like job demands (physical-demanding jobs vs. intellectual-demanding jobs) or age.