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JAMA Netw Open. 2018 Nov 2;1(7):e184831. doi: 10.1001/jamanetworkopen.2018.4831.

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

Author information

1
Health Care and International Medical Services, Peking Union Medical College Hospital, Beijing, People's Republic of China.
2
Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut.
3
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.
4
Department of Biomedical and Health Informatics, University of Missouri-Kansas City.
5
Department of Cardiovascular Research, St Luke's Mid America Heart Institute, Kansas City, Missouri.
6
Department of Medicine, University of Colorado School of Medicine at the Anschutz Medical Campus, Aurora.
7
Colorado Cardiovascular Outcomes Research Consortium, Denver.
8
National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
9
Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
10
Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.
11
Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut.
12
Department of Cardiology, Peking University People's Hospital, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Beijing, People's Republic of 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.

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