Factors Associated With Return to Work After Acute Myocardial Infarction in China

Abstract

Importance Return to work is an important indicator of recovery after acute myocardial infarction. Little is known, however, about the rate of returning to work within the year after an acute myocardial infarction in China, as well as the factors associated with returning to work after an acute myocardial infarction. Objectives To determine the rate of return to work within 12 months after acute myocardial infarction, classify the reasons why patients did not return to work, and identify patient factors associated with returning to work. Design, Setting, and Participants This prospective cohort study, conducted in 53 hospitals across 21 provinces in China, identified 1566 patients who were employed at the time of the index acute myocardial infarction hospitalization and participating in the China Patient-centered Evaluative Assessment of Cardiac Events Prospective Study of Acute Myocardial Infarction. Data collected included patients’ baseline characteristics; employment status at 12 months after acute myocardial infarction; and, for those who were not employed at 12 months, potential reasons for not returning to work. A logistic regression model was fitted to identify factors associated with returning to work at 12 months. Data were collected from January 1, 2013, through July 17, 2014, and statistical analysis was conducted from August 9, 2016, to August 15, 2018. Main Outcomes and Measures Return to work, defined as rejoining the workforce within 12 months after discharge from hospitalization for the index acute myocardial infarction. Results Of 1566 patients (130 women and 1436 men; mean [SD] age, 52.2 [9.7] years), 875 patients (55.9%; 95% CI, 53.4%-58.3%) returned to work by 12 months after acute myocardial infarction. Among the 691 patients who did not return to work, 287 (41.5%) were unable to work and/or preferred not to work because of acute myocardial infarction and 131 (19.0%) retired early owing to the acute myocardial infarction. Female sex (relative risk, 0.65; 95% CI, 0.41-0.88), a history of smoking (relative risk, 0.82; 95% CI, 0.65-0.98), and in-hospital complications during the index acute myocardial infarction (relative risk, 0.96; 95% CI, 0.93-0.99) were associated with a lower likelihood of returning to work. Conclusions and Relevance Almost half of the previously employed Chinese patients did not return to work within 12 months after acute myocardial infarction. Female sex, history of smoking, and in-hospital complications were associated with a lower likelihood of returning to work. Trial Registration ClinicalTrials.gov Identifier: NCT01624909

Factors associated with return to work following myocardial infarction: A systematic review of observational studies

“…Nine studies provided a definition for RTW. In five studies, ‘work’ was considered to refer to full‐time or part‐time working, or working hours were identified (Attarchi et al, 2012; Fukuoka et al, 2009; Jiang et al, 2018; Laut et al, 2014; Warraich et al, 2018). One study considered participants engaged in paid work (Dreyer et al, 2016).…”

“…Of eight studies that followed participants for 12 months, seven reported the percentage of patients who RTW exceeding 70% (Dreyer et al, 2016; de Jonge et al, 2014; Laut et al, 2014; Mirmohammadi et al, 2014; Smedegaard et al, 2017; Stendardo et al, 2018; Warraich et al, 2018) with the remaining study at 55.9% of patients (Jiang et al, 2018). In three of these eight studies that examined this, the proportion of patients who RTW at one‐year follow‐up reached 90% (Smedegaard et al, 2017; Stendardo et al, 2018; Warraich et al, 2018).…”

“…Consistently, a link was demonstrated between older age and lesser likelihood of RTW. Seven studies that investigated this demonstrated strong associations between age and RTW, all of which linked increasing age with reducing proportions of patients who RTW (Attarchi et al, 2012; Brink et al, 2008; Isaaz et al, 2010; Jiang et al, 2018; de Jonge et al, 2014; Laut et al, 2014; Waszkowska & Szymczak, 2009).…”

Long Noncoding RNA SOX2-OT Exacerbates Hypoxia-Induced Cardiomyocytes Injury by Regulating miR-27a-3p/TGFβR1 Axis

“…In recent years, the occurrence of MI has been increasing in China [26]. About 500,000 individuals have been diagnosed with MI each year at least and approximately 2 million are suffering from MI [27].…”

Quality indicators for cardiac rehabilitation after myocardial infarction in China: a consensus panel and practice test

“… 4 Only 55.9% of Chinese patients return to work within 12 months after AMI. 5 Among the hospitalisation expenses for cardiovascular and cerebrovascular diseases in 2016, AMI accounted for 19.085 billion yuan. 4 Thus, Chinese people with a history of MI represent a substantial healthcare burden.…”