Self-reported mental and physical health is associated with not returning to work in patients with ischemic heart disease

Background: Ischemic Heart Disease (IHD) can lead to prolonged sick leave and loss of ability to work. This study
aimed to describe non-return to work (non-RTW) across three IHD subgroups at 3 and at 12 months post
discharge, and explore whether baseline characteristics, and patient-reported mental and physical health were
associated with work detachment.
Methods: Data from the national cohort study DenHeart were used, including the patient-reported outcomes
(PROs) Short-Form 12, Hospital Anxiety and Depression Scale, Edmonton Symptom Assessment Scale and
HeartQoL measured at discharge and register-based follow-up at 3 and at 12 months. A total of 3873 patients
with IHD ≤ 63 years old and part of the workforce prior to hospitalisation, were included in the analyses and
divided into three groups: chronic IHD/stable angina, non-STEMI (non-ST-Elevation Myocardial Infarction)/
unstable angina and STEMI (ST-Elevation Myocardial Infarction). A composite outcome of ‘prolonged sick leave’
and/or ‘left the workforce’ was defined as non-return to work (non-RTW). Adjusted logistic regression models
were performed.
Results: Overall, the frequency of non-RTW was 37.7% and 38.0% at 3 and 12 months, respectively, thus not
improving with time. The largest proportion of non-RTW was found in STEMI patients, followed by non-STEMI/
unstable angina and IHD/stable angina patients. Several clinical and socio-demographic factors, as well as
patient-reported mental and physical health were associated with non-RTW among the subgroups.
Conclusion: The findings demonstrate a need for identifying IHD patients at risk of non-RTW after discharge based
on their mental and physical health and a need for initiatives to minimize unwanted non-RTW.