Evaluation of factors influencing return to work in STEMI patients: A case-control study

Abstract

This study aimed to evaluate return to work (RTW) across different job groups, identify predictors of successful RTW, and investigate reasons for RTW failure. This case-control study, conducted in 2022, included 164 male patients who had ST elevation myocardial infarction (STEMI) in 2016 to 2017 and were registered in the 5-year ST Elevation Myocardial Infarction Cohort in Isfahan, Iran. Patients were divided into RTW (n = 82) and RTW failure (n = 82) groups, frequency-matched for education, marital status, and comorbidities. Baseline data were extracted from the cohort database, and occupational factors were gathered via telephone contact. Statistical analysis was performed using chi-square tests, t tests, and multivariate logistic regression to identify significant predictors of RTW, with P < .05 considered statistically significant. Data from 164 patients aged 18 to 65 with STEMI showed that those who returned to work had a mean age of 49.05 years, compared to 53.04 years for those who did not (P = .001). Factors associated with increased RTW included younger age (odds ratios OR: 0.86; 95% confidence intervals: 0.77-0.95), shorter hospitalization (OR: 0.63; 0.44-0.91), and lower first systolic blood pressure (OR: 0.97; 0.94-0.99). Most patients (49.39%, n = 59) returned within 1 month. Common RTW failure reasons were personal decisions (36.58%, n = 30), retirement (25.61%, n = 21), and choosing lighter jobs (25.61%, n = 21). No significant relationship was found between job groups of the International Standard Classification of Occupations and RTW (P = .581). Our study identifies key factors influencing RTW after STEMI, including age, history of myocardial infarction, hospitalization duration, treatment methods, and initial systolic blood pressure. The most common barrier to RTW was patient unwillingness. A comprehensive approach that integrates primary prevention, personalized rehabilitation, and financial and social support is recommended to improve RTW outcomes.