Strategies for improving the work status of patients after coronary artery bypass surgery.
Postoperative work status was evaluated by follow-up questionnaire in 326 men who underwent coronary bypass graft surgery (CABG) between September 1969 and December 1972 (mean follow-up 30 months) and in 1217 men younger than age 60 years operated upon between January 1973 and June 1978 (mean follow-up 36 months). Work status was also assessed 1 year after operation in 59 men younger than age 60 years enrolled in a pilot rehabilitation program between November 1978 and March 1980 and in 62 comparable patients who underwent CABG during the same period but did not participate in the program. The percentage of patients working at completion of follow-up was 58% in the first survey, 61% in the second survey, 86% in the pilot study and 82% in the control group. The percentages of patients who resumed work during follow-up were 69%, 76%, 92% and 89% in the respective groups. This improvement was related primarily to a shorter period of preoperative unemployment; the percentage of patients operated on after less than 3 months of inactivity increased from 20% between 1969 and 1972, to 50% between 1973 and 1978, to 84% in 1979-1980. The prognosis for return to work was influenced, in order of predictive value, by the length of preoperative unemployment, type of physical activity in preoperative occupation, noncardiovascular illness, education, anginal class and duration of symptoms. Of patients with a good or excellent preoperative prognosis, 94% were working 1 year after CABG. We conclude that the working status of patients after CABG is excellent in subgroups with preoperative unemployment of 3 months or less and in a socioeconomic level above poverty; application  of an individualized postoperative rehabilitation program should be limited to patients whose prognosis for return to work is poor according to the above predictive factors and the psychosocial evaluation.
D000328:Adult; D000787:Angina Pectoris / Q000523:psychology / Q000534:rehabilitation / Q000601:surgery; D001026:Coronary Artery Bypass / Q000534:rehabilitation*; D004522:Educational Status; D004651:Employment; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D010865:Pilot Projects; D011336:Probability; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014478:Unemployment