Impact of Health Care System Delay in Patients With ST-Elevation Myocardial Infarction on Return to Labor Market and Work Retirement

Laut, Kristina Grønborg; Hjort, Jacob; Engstrøm, Thomas; Jensen, Lisette Okkels; Hansen, Hans-Henrik Tilsted; Jensen, Jan Skov; Pedersen, Frants; Jørgensen, Erik; Holmvang, Lene; Pedersen, Alma B; Christensen, Erika Frischknecht; Lippert, Freddy; Lang-Jensen, T; Jans, H; Hansen, Poul Anders; Trautner, Sven; Kristensen, Steen Dalby; Lassen, Jens Flensted; Lash, Timothy L.; Clemmensen, Peter; Terkelsen, Christian Juhl

doi:10.1016/j.amjcard.2014.09.018

Cited by 24 publications

(38 citation statements)

References 27 publications

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“…Still, the proportion of patients returning to work in our study was somewhat lower than in most studies. 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.…”

Section: Discussionsupporting

confidence: 66%

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

Funder

Rasmussen

Siersma

et al. 2018

Acta Anaesthesiol Scand

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BackgroundImplementation of the first Danish helicopter emergency medical service (HEMS) was associated with reduced time from first medical contact to treatment at a specialized centre for patients with suspected ST elevation myocardial infarction (STEMI). We aimed to investigate effects of HEMS on mortality and labour market affiliation in patients admitted for primary percutaneous coronary intervention (PCI).MethodsIn this prospective observational study, we included patients with suspected STEMI within the region covered by the HEMS from January 1, 2010, to April 30, 2013, transported by either HEMS or ground emergency medical services (GEMS) to the regional PCI centre. The primary outcome was 30‐day mortality.ResultsAmong the 384 HEMS and 1220 GEMS patients, time from diagnostic ECG to PCI centre arrival was lower with HEMS (median 71 min vs. 78 min with GEMS; P = 0.004). Thirty‐day mortality was 5.0% and 6.2%, respectively (adjusted OR = 0.82, 95% CI 0.44–1.51, P = 0.52. Involuntary early retirement rates were 0.62 (HEMS) and 0.94 (GEMS) per 100 PYR (adjusted IRR = 0.68, 0.15–3.23, P = 0.63). The proportion of patients on social transfer payments longer than half of the follow‐up time was 22.1% (HEMS) vs. 21.2% (adjusted OR = 1.10, 0.64–1.90, P = 0.73).ConclusionIn an observational study of patients with suspected STEMI in eastern Denmark, no significant beneficial effect of helicopter transport could be detected on mortality, premature labour market exit or work ability. Only a study with random allocation to one system vs. another, along with a large sample size, will allow determination of superiority of helicopter transport.

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Section: Discussionsupporting

confidence: 66%

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

Funder

Rasmussen

Siersma

et al. 2018

Acta Anaesthesiol Scand

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“…Despite the recent advancement of acute management in AMI patients which led to an increasing number of patients returning to work after an acute coronary syndrome, approximately 15% of AMI patients at working age do not return to work within 1 year, this owing to the fact that AMI patients present at least one comorbidity burden. 1 Moreover, the percentage of AMI patients who returned to their previous jobs remains almost similar to the one recorded in the last century, ranging between 15-25%. 2 From an economic point of view, AMI involves a substantial socioeconomic burden.…”

supporting

confidence: 56%

“…With 40% of AMI survivors at working age according to WHO reports, and an increasing value in the next decades due to the aging process of the working population, employment in the post-infarction period can generate significant socioeconomic outcomes. 1 Based on experts' agreement, the main factors related to return to work were the patients' rehabilitation, age, educational status, social support, and job satisfaction.…”

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confidence: 99%

Can We Reduce the Socioeconomic Burden of Acute Myocardial Infarction Already in the Acute Phase?

Samu

2018

Journal of Cardiovascular Emergencies

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In patients with acute myocardial infarction (AMI) who survive the acute coronary event, the acute phase represents only the first part of a long-term journey. Work reinsertion after AMI remains a significant part of a successful recovery, a process in which a complete social reintegration involves a complex interplay between clinical, psychological, socio-demographic, and occupational factors.With 40% of AMI survivors at working age according to WHO reports, and an increasing value in the next decades due to the aging process of the working population, employment in the post-infarction period can generate significant socioeconomic outcomes. 1 Based on experts' agreement, the main factors related to return to work were the patients' rehabilitation, age, educational status, social support, and job satisfaction.Despite the recent advancement of acute management in AMI patients which led to an increasing number of patients returning to work after an acute coronary syndrome, approximately 15% of AMI patients at working age do not return to work within 1 year, this owing to the fact that AMI patients present at least one comorbidity burden. 1 Moreover, the percentage of AMI patients who returned to their previous jobs remains almost similar to the one recorded in the last century, ranging between 15-25%. 2From an economic point of view, AMI involves a substantial socioeconomic burden. In order to establish the cost-of-illness related to AMI, it is mandatory to consider both direct and indirect costs. Direct healthcare costs are those related to treatment and caregivers, while the indirect costs are those related to loss of productivity at the workplace and at home, which could also have damaging consequences. Indirect costs include those related to morbidity (the days of work lost due to AMI and home productivity loss) and those resulting from mortality (the value of lost earnings and household productivity from premature death due to AMI). With individuals aged between 45-64 facing the highest indirect costs, it has been estimated that in the European Union, 90 million working days are lost a year due to AMI morbidity, being the leading cause of disability-adjusted life-years. 2,3 In order to improve the social reinsertion of AMI patients, the current trend of cardiovascular rehabilitation is to include a comprehensive therapeutic approach. Besides standard implemented invasive therapy followed by medical treatment and out-of-hospital cardiac rehabilitation, recent studies showed that early rehabilitation nursing by early mobilization, functional exercise guidance, diet care, pain and mental nursing, initiated after 24 h of stable vital parameters, can significantly improve the prognosis of AMI patients, resume work ability, and reduce the family and society burden. 3 Moreover, occupational therapy associated with disease self-management, via counselling and therapeutic education interventions, can significantly reduce the risk of sub-optimal patient recovery. 4 It is obvious that AMI has several consequences in term...

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“…[7][8][9][10][11][12] In ST-segment elevation MI patients, rates varied between 76% and 93%. 26,27 The potentially slightly higher return to work rates observed in our study could be caused, in part, by our register-based design that minimized loss to follow-up. Furthermore, compared with other countries, all Danish citizens have the possibility of a paid sick leave, which may contribute to resumption of work.…”

Section: Discussionmentioning

confidence: 81%

Return to Work and Risk of Subsequent Detachment From Employment After Myocardial Infarction: Insights From Danish Nationwide Registries

Smedegaard

Numé

Charlot

et al. 2017

JAHA

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BackgroundLimited data are available on return to work and subsequent detachment from employment after admission for myocardial infarction (MI).Methods and ResultsUsing individual‐level linkage of data from nationwide registries, we identified patients of working age (30–65 years) discharged after first‐time MI in the period 1997 to 2012, who were employed before admission. To assess the cumulative incidence of return to work and detachment from employment, the Aalen Johansen estimator was used. Incidences were compared with population controls matched on age and sex. Logistic regression was applied to estimate odds ratios for associations between detachment from employment and age, sex, comorbidities, income, and education level. Of 39 296 patients of working age discharged after first‐time MI, 22 394 (56.9%) were employed before admission. Within 1 year 91.1% (95% confidence interval [CI], 90.7%–91.5%) of subjects had returned to work, but 1 year after their return 24.2% (95% CI, 23.6%–24.8%) were detached from employment and received social benefits. Detachment rates were highest in patients aged 60 to 65 and 30 to 39 years, and significantly higher in patients with MI compared with population controls. Predictors of detachment were heart failure (odds ratio 1.20 [95% CI, 1.08–1.34]), diabetes mellitus (odds ratio 1.13 [95% CI, 1.01–1.25]), and depression (odds ratio 1.77 [95% CI, 1.55–2.01]). High education level and high income favored continued employment.ConclusionsDespite that most patients returned to work after first‐time MI, about 1 in 4 was detached from employment after 1 year. Several factors including age and lower socioeconomic status were associated with risk of detachment from employment.

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Impact of Health Care System Delay in Patients With ST-Elevation Myocardial Infarction on Return to Labor Market and Work Retirement

Cited by 24 publications

References 27 publications

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

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

Can We Reduce the Socioeconomic Burden of Acute Myocardial Infarction Already in the Acute Phase?

Return to Work and Risk of Subsequent Detachment From Employment After Myocardial Infarction: Insights From Danish Nationwide Registries

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