Employment patterns in males before and after myocardial revascularization sugery. A study of 2229 consecutive male patients followed for as long as 10 years

Abstract

Loss of productivity is a major concern among patients with heart disease. To assess the effect of surgery on this factor, we surveyed every living male patient of the surgeon authors operated on from January 1968 through March 1978 (96% follow-up) and compared their pre- and postoperative work status with the U.S. population as reported by the U.S. Bureau of Labor Statistics (USBLS). Comparisons were made on an age-for-age basis and adjustments were made for changes in national employment patterns from 1968-1978. Preoperatively, our younger patients had a 10% lower employment rate than the U.S. male population at large according to the USBLS. Postoperatively, many returned to work, but an equal number who worked preoperatively did not postoperatively. The ability to work full timewith little or no limitation increased 20% after operation. The main reason for not working was physical disability, with doctor's advice a distant second. Older patients showed a trend of accelerated retirement after surgery. A few returned to work, but many more retired. The ability to work full-time without limitation increased 4%. Thirty percent of all older subjects in later years were older and did not show as much preoperative disability. There was some evidence of a deterioration of the effects of surgery. Patients with severely impaired left ventricular function fared worse both pre- and postoperatively, but the improvement was the same as for patients with normal or moderately impaired left ventricular function.