Chapter 8. Sick leave due to coronary artery disease or stroke

Abstract

The assessment of the literature on sick-leave with cardiovascular diseases include only studies with sufficient scientific quality. These studies describe sick leave following stroke, myocardial infarction, coronary artery bypass grafting (CABG), or percutaneous coronary intervention (PCI). We found limited scientific evidence for the following results: After stroke, more than half of the patients of working age returned to work (RTW) during the first year following onset (higher rate for the younger patients). The consequences of brain damage, e.g. impaired ADL ability or cognitive capacity, play an important role in this respect. Also after myocardial infarction most patients RTW. PCI is a milder coronary artery intervention than CABG and RTW is more rapid. However, in the long run there are no differences in sick leave. People at higher ages or with physically demanding jobs return to work to a lesser degree. An international comparison shows that the duration of sick leave due to these conditions in Sweden is longer than in other countries although there is no scientific evidence to support this practice. It appears that the interest in research on sick leave in patients with cardiovascular diseases has waned in recent years. Developments in acute cardiological care should inspire renewed scientific involvement in this area of research.

The joint contribution of cardiovascular disease and socioeconomic status to disability retirement: A register linkage study

“…Our findings of a two-fold independent risk of disability retirement associated with low occupational class and CVD confirms previous research that has reported associations of low socioeconomic status [14,15] and CVD [6][7][8][9][10] with work disability. We found support for our hypothesis that low occupational class and CVD together might assert their influence on work disability pension over and above their independent effects.…”

“…As the workforce is aging, CVD is not uncommon in working-age populations, and due to more effective treatments, many CVD patients remain in employment despite illnesses [5]. However, CVD is a major risk factor for premature exit from the labour market, as indicated by work disability retirement [6][7][8][9][10].…”

“…However, we are not aware of studies that have examined whether this gradient is similar for people with and without CVD. Most of the research on this topic has focused on the short-term effect of socioeconomic status on return to work in a patient group (e.g., CVD) hospitalized or functionally disabled [6,8,9]. Knowing not only the risk factors but also combinations of risk factors is important for policies aiming at reducing socioeconomic inequalities in health and functional capacity among working populations.…”

Helicopter vs. ground transportation of patients bound for primary percutaneous coronary intervention

“…In a study by Laut et al, for example, up to 90% of patients had returned to work after 1 year16, and another study found that almost 80% of STEMI patients had resumed work after approximately 6 months17. These findings are consistent with those of a Swedish review in which it was estimated that as many as three of four patients return to work18.…”

Work is central to doctors’ identity, and those unable to work need support

“…Any persisting or recurring symptoms may then fit the description of a 'common health problem' . Cardiorespiratory conditions have a high prevalence in the general population (Perk & Alexanderson 2004;Tarlo & Liss 2005); whilst certain characteristics of work can be risk factors, cardiorespiratory conditions are often multifactorial in nature. Table 6a presents the evidence on common cardiovascular conditions (myocardial infarction, heart failure and hypertension), arranged in two sections covering work as a risk factor (Table 6a-i) and management (Table 6a-ii).…”