Abstract 13771: Cardiopulmonary Exercise Testing is Predictive of Return to Work in Cardiac Patients After Rehabilitation
Introduction: Cardiopulmonary exercise testing (CPX) has an independent prognostic value, especially in cardiovascular patients. We aimed to evaluate parameters of CPX as predictors for return to work (RTW) at discharge of cardiac rehabilitation (CR).
Hypothesis: Besides psychosocial as well as clinical parameters CPX variables are independent predictors of return to work in patients with cardiovascular diseases.
Methods: We analysed sociodemographic and clinical data from a prospective registry of 489 patients (mean age 51.5±6.9 years, 87.9% men), who were referred to shortterm (3 weeks) inpatient CR between 06/2009 to 12/2011, predominantly after PCI (62.6%), CABG (17.2%) and heart valve replacement (9.0%). At admission, patients underwent noninvasive cardiac diagnostic (2D echo, exercise ECG, 6MWT) and a psychodiagnostic screening (HADS). CPX was performed at discharge for defining fitness.
Results: During a mean follow up of 26.5±11.9 months 373 (76.3%) patients returned to work, 116 (23.7%) did not and 60 (12.3%) were retired. A higher number of comorbidities (p=0.011) and heavy work (p<0.001) were negatively associated with RTW whereas a higher exercise capacity at entry of CR (p<0.001) and elective PCI (p=0.02) increased the probability of RTW. After adjustment for covariates, max. work load (Watt) at CPX termination and the VE/VCO2-slope had an independent prognostic significance for RTW. A higher work load increased (p=0.009) while a higher VE/VCO2-slope decreased (p=0.027) the probability of RTW. Even for retirement, CPX had a prognostic value: the likelihood of retirement was smaller with increasing VO2AT (p=0.016).
Conclusion: CPX is a meaningful tool to assess patients’ ability for return to work. Therefore it should be an essential part of functional assessment in CR for predicting participation in employment during two years after CR.
- Cardiac rehabilitation
- Exercise tests
- Cardiorespiratory fitness
- Health services research
- Physical activity
Author Disclosures: H. Voller: None. A. Salzwedel: None. R. Reibis: None. S. Kaminski: None. H. Buhlert: None. S. Eichler: None. K. Wegscheider: None.
This research has received full or partial funding support from the American Heart Association.
- © 2014 by American Heart Association, Inc.