Document Detail


Referral to occupational medicine clinics and resumption of employment after myocardial infarction.
MedLine Citation:
PMID:  10570498     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Rehabilitation after acute myocardial infarction (AMI) consists of education, exercise, and an encouragement to return to work (RTW). This study attempts to (1) determine whether the time interval between AMI and the visit at occupational medicine (OM) clinics predicts resumption of full employment, and (2) estimate the incidence of work-related recurrent AMI after RTW. We followed 216 consecutive AMI patients at a single OM clinic. The independent variables were clinical and personal data, physical workload and time between AMI, and first visit to the OM clinic. The outcome variables were full employment 24 months after the acute event and recurrent AMI during this period. Of all patients, 168 attempted RTW. Of these, 18 stopped working subsequently. Of the remaining 150 patients, 54 returned to part-time work and 96 were employed full-time after 2 years. Logistic regression indicated that a failure to resume full employment was independently associated with diabetes, older age, Q wave AMI, angina before AMI, heavy work, and a late visit to the OM clinic. For each month's delay in referral to the OM clinic, there was a 30% decrease in the chance for full employment 24 months after AMI. Six (4%) of the 150 patients who resumed employment sustained a recurrent AMI, two of them while at work. A delayed referral to the OM clinic was associated with work disability after AMI. Late referrals to OM clinics should receive a more intensive and sustained rehabilitation than early referrals. Whether an earlier referral to OM clinics will result in increased RTW rates is unknown. Patients who attempted to resume employment had a 1.2% risk of a recurrent ischemic event at their workplace.
Authors:
P Froom; C Cohen; J Rashcupkin; E Kristal-Boneh; S Melamed; J Benbassat; J Ribak
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine     Volume:  41     ISSN:  1076-2752     ISO Abbreviation:  J. Occup. Environ. Med.     Publication Date:  1999 Nov 
Date Detail:
Created Date:  1999-12-21     Completed Date:  1999-12-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9504688     Medline TA:  J Occup Environ Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  943-7     Citation Subset:  IM    
Affiliation:
Occupational Health Institute, Raanana, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adult
Ambulatory Care Facilities
Chi-Square Distribution
Confidence Intervals
Employment / statistics & numerical data*,  trends
Female
Follow-Up Studies
Humans
Israel
Logistic Models
Male
Middle Aged
Monitoring, Physiologic / methods
Multivariate Analysis
Myocardial Infarction / diagnosis,  epidemiology*,  rehabilitation*
Occupational Medicine / statistics & numerical data*
Recurrence
Referral and Consultation / statistics & numerical data*,  trends
Risk Assessment
Sampling Studies
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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