Journal Article

Predictors of permanent work disability among ≤50-year-old patients undergoing percutaneous coronary intervention

Mäkikallio, Timo, Eskola, Markku, Korpilahti, Kari, Airaksinen, Juhani, Kajander, Olli, Ilveskoski, Erkki, Heikkinen, Jouni, Biancari, Fausto, Anttila, Vesa, Gunn, Jarmo, Kiviniemi, Tuomas, Wistbacka, Jan-Ola

2015

Overview

Objectives This study aimed to describe the incidence and periprocedural predictors of permanent work disability (PWD) pension among patients ≤50 years old who underwent percutaneous coronary intervention (PCI). Methods Patient records of 910 consecutive patients undergoing PCI at four Finnish hospitals in 2002–2012 were reviewed for baseline and procedural data and late adverse events. Data on permanent work disability (PWD) pension allocation were acquired from the Finnish Centre for Pensions, which governs the statutory pension security in Finland. Results Mean follow-up was 41 [standard deviation (SD) 31] months. Altogether 103/910 (11.3%) of patients were on PWD by the end of follow-up, 60 (58.3%) for cardiac diagnoses (cumulative freedom from PWD 81% at 7 years). Independent predictors of PWD were post procedural stroke [hazard ratio (HR) 4.7, 95% confidence interval (95% CI) 1.8–11.9], post procedural myocardial infarction (MI) (HR 3.3, 95% CI 1.8–6.0), diabetes (HR 2.0, 95% CI 1.1–3.7), discharge diuretics (HR 3.5, 95% CI 2.1–5.9), and increasing age (HR 1.2, 95% CI 1.1–1.3). Predictors of PWD for cardiac diagnoses were post procedural stroke and MI, discharge diuretics, and use of calcium-channel blockers, diabetes and older age. Conclusions Patients ≤50 years old undergoing PCI are at a high risk for subsequent permanent disability for cardiac diagnoses. This finding underscores the need for reinforcing adherence to secondary prevention by cardiac rehabilitation and early collaboration with occupational health care professionals.

• Publisher: Nordic Association of Occupational Safety and Health,Scandinavian Journal of Work, Environment & Health,Nordic Association of Occupational Safety and Health (NOROSH)
• Subject: Age / Age Factors / Angioplasty / Calcium / Calcium channels / Cardiac surgery / Cardiovascular disease / Collaboration / Confidence intervals / Coronary artery disease / Coronary vessels / Critical incidents / Defined benefit pension plan / Diabetes / Diabetes Mellitus - epidemiology / Disabilities / Disability / Disability pensions / Disabled Persons - statistics & numerical data / Discharge / Diuretics / Female / Finland - epidemiology / Health outcomes / Heart attacks / High risk / Hospitals / Humans / Intervention / Language acquisition / Male / Middle Aged / Myocardial infarction / Myocardial Infarction - epidemiology / Occupational health / Patients / Pensions / People with disabilities / percutaneous coronary intervention / Percutaneous Coronary Intervention - statistics & numerical data / Percutaneous transluminal coronary angioplasty / permanent work disability / predictor / Proportional Hazards Models / Return to Work - statistics & numerical data / Stroke / Stroke - epidemiology / Strokes / Time Factors / Vein & artery diseases / work disability / young age