[Return to work after cardiovascular rehabilitation in 128 coronary patients followed for 7 years. Results and medico-economic analysis]. / Réinsertion professionnelle après réadaptation cardiovasculaire chez 128 patients coronariens suivis pendant 7 ans. Résultats et réflexion médico-économique.

This was a prospective study of the modalities of return to work in a male population of 128 patients (mean age 48.9 years)) admitted for cardiovascular rehabilitation after acute infarction or coronary bypass surgery and followed up for 7 years. At one year, 78.9% of the population had returned to work (average delay 126 +/- 97 days), usually to the same job (66.3%) after adaptation (25.8%) or professional reconversion (7.9%). After 3 and 7 years follow-up, the active population was 62.5% and 40.7% respectively and the main reason for definite stopping work was retirement (63%). Temporary stoppages were short (4.5 days and 8.2 days per patient per year at 3 and 7 years respectively), illustrating the good quality of professional rehabilitation. The factors influencing return to work during the first age were young age (47.5 versus 52.7 years) and negative exercise stress tests (83% versus 59% in cases of positive tests, p < 0.05). This study and a review of the literature were used to undertake a medico-economic analysis which showed decreased economic consequences in patients referred for rehabilitation: over 5 years in a group of 100 patients, an economy of 5,818 KF after myocardial infarction or 2,677 KF after coronary bypass surgery was demonstrated. The reasons for these economies were the reduced direct (hospital admissions) and indirect costs (social security reimbursement for off-work and invalidity pensions). Those favourable results underline the value of a consultation of professional aptitude in all programmes of cardiovascular rehabilitation.