Anna Kiessling1, Peter Henriksson. 1. Centre for Clinical Education, Karolinska Institute at Danderyd University Hospital, Stockholm, Sweden. Anna.Kiessling@kids.ki.se
Abstract
OBJECTIVE: We aimed to assess whether perceived cognitive function influences employment and return to work in patients with coronary artery disease (CAD). DESIGN: Prospective longitudinal cohort study. SETTING: Health care system of Södertälje, Stockholm County, Sweden. PATIENTS: We included consecutive unselected patients less than 65 years of age with CAD and followed them during 2 years. MAIN OUTCOME MEASURES: Gainful employment and return to work in patients with CAD. RESULTS: We found that perceived cognitive function predicts both prevalence of unemployment [OR 2.06 (95% CI: 1.36-3.13); p = 0.0006] and early retirement and sick leave due to coronary artery disease [OR 1.59 (95% CI: 1.12-2.25)] both at baseline and 2 years later. Furthermore, perceived cognitive function predicted return to work after an acute coronary event [OR 2.28 (95% CI: 1.08-4.84)]. Covariates such as age, sex, prevalence and degree of angina (CCS grade), cardiovascular risk factors and events did not change the predictive power. CONCLUSIONS: Perceived cognitive function is a hitherto unrecognised independent predictor of unemployment, sick leave and return to work in patients with coronary artery disease. Perceived cognitive function adds a new perspective on ability to gainful employment in patients with CAD. The findings might have significance both to individual care and to society.
OBJECTIVE: We aimed to assess whether perceived cognitive function influences employment and return to work in patients with coronary artery disease (CAD). DESIGN: Prospective longitudinal cohort study. SETTING: Health care system of Södertälje, Stockholm County, Sweden. PATIENTS: We included consecutive unselected patients less than 65 years of age with CAD and followed them during 2 years. MAIN OUTCOME MEASURES: Gainful employment and return to work in patients with CAD. RESULTS: We found that perceived cognitive function predicts both prevalence of unemployment [OR 2.06 (95% CI: 1.36-3.13); p = 0.0006] and early retirement and sick leave due to coronary artery disease [OR 1.59 (95% CI: 1.12-2.25)] both at baseline and 2 years later. Furthermore, perceived cognitive function predicted return to work after an acute coronary event [OR 2.28 (95% CI: 1.08-4.84)]. Covariates such as age, sex, prevalence and degree of angina (CCS grade), cardiovascular risk factors and events did not change the predictive power. CONCLUSIONS: Perceived cognitive function is a hitherto unrecognised independent predictor of unemployment, sick leave and return to work in patients with coronary artery disease. Perceived cognitive function adds a new perspective on ability to gainful employment in patients with CAD. The findings might have significance both to individual care and to society.
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