A1 Refereed original research article in a scientific journal

Permanent work disability in patients ≤50 years old after percutaneous coronary intervention and coronary artery bypass grafting (the CRAGS study)




AuthorsAnna Lautamäki, Jarmo M. Gunn, Kari Eino Juhani Airaksinen, Fausto Biancari, Olli A. Kajander, Vesa Anttila, Jouni Heikkinen, Markku Eskola, Erkki Ilveskoski, Ari Mennander, Kari Korpilahti, Jan-Ola Wistbacka, Tuomas O. Kiviniemi

Publication year2017

JournalEuropean Heart Journal - Quality of Care and Clinical Outcomes

Volume3

Issue2

First page 101

Last page106

Number of pages6

ISSN2058-5225

DOIhttps://doi.org/10.1093/ehjqcco/qcw043(external)


Abstract
Background:

The aim of this study was to investigate the incidence of permanent working disability (PWD) in young patients after percutaneous or surgical coronary revascularization.

Methods and Results:

The study included 1035 consecutive patients ≤50 years old who underwent coronary revascularization [910 and 125 patients in percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) groups, respectively] between 2002 and 2012 at 4 Finnish hospitals. The median follow-up time was 41 months. The overall incidence of PWD was higher after CABG compared to PCI (at 5 years, 34.8 vs. 14.7%, P < 0.001). Freedom from PWD in the general population aged 45 was 97.2% at 4 years follow-up. Median time to grant disability pension was 11.6 months after CABG and 24.4 months after PCI (P = 0.018). Reasons for PWD were classified as cardiac (35.3 vs. 36.9%), psychiatric (14.7 vs. 14.6%), and musculoskeletal (14.7 vs. 15.5%) in patients undergoing CABG vs. PCI. Overall freedom from PWD was higher in patients without major adverse cardiac and cerebrovascular event (MACCE) (at 5 years, 85.6 vs. 71.9%, P < 0.001). Nevertheless, rate of PWD was high also in patients without MACCE and patients with preserved ejection fraction during follow-up.

Conclusions:

Although coronary revascularization confers good overall survival in young patients, PWD is common especially after CABG and mostly for cardiac reasons even without occurrence of MACCE. Supportive measures to preserve occupational health are warranted concomitantly with coronary revascularization at all levels of health care.



Last updated on 2024-26-11 at 14:13