Incapacidad laboral permanente en pacientes menores de 62 años sometidos a cardiocirugía abierta: Estudio monocéntrico de un trienio

espanolIntroduccion y objetivos. Aunque tras la cirugia cardiaca abierta la calidad de vida mejora, la reinsercion laboral no siempre es posible. Nuestro objetivo es identificar cuando es mas frecuente la incapacidad laboral permanente tras la cirugia y cuales son los factores predisponentes. Metodos. Los 204 menores de 62 anos intervenidos de cirugia cardiaca entre 2010 y 2012 se estudiaron pre y postoperatoriamente. Resultados. Edad media 51±9 anos, 156 (76,5%) varones, Euroscore Logistico 5,1±8,4; fraccion de eyeccion ventricular izquierda 58±11%; 86 (42,2%) coronarios, 79 (38,7%) valvulares, 16 (7,8%) cirugias combinadas y 23 (11,3%) otras. Trabajadores autonomos fueron 28 (13,7%), 176 (86,33%) por cuenta ajena; 90 obtuvieron la incapacidad laboral permanente en 5,8±3,4 meses (15 ya la tenian al operarse). Los pacientes que obtuvieron la incapacidad laboral permanente presentaban, de forma estadisticamente significativa, un Euroscore mayor y mayor edad; sin diferencias en la fraccion de eyeccion. Entre mujeres hubo mas incapacidad laboral permanente y estando en incapacidad laboral permanente, mas con cirugia valvular 67% que otra cirugia, p=0,013. Mayor numero de puentes, ser trabajador autonomo o ser intervenido de alguna valvula, asi como el numero de valvulas intervenidas, se asocio a mas incapacidad laboral permanente. Conclusiones La edad, comorbilidad, sexo femenino, ser trabajador autonomo y el tipo de intervencion fueron predictores para la incapacidad laboral permanente tras la cirugia cardiaca. La cirugia valvular, el numero de valvulas y el de puentes coronarios determinan en mayor grado la probabilidad acumulada de incapacidad laboral permanente. EnglishIntroduction and objectives. Although the quality of life after cardiac-surgery usually improves, the reintegration to work is not always possible. Our target is to identify what patients would have less probability of reintegration to work after open-heart surgery. Methods. We studied 204 patients younger than 62 years who underwent cardiac surgery between 2010 and 2012. Data was recorded and analysed. Results. Average age 51±9 years, 156 (76.5 %) males, Logistic Euroscore 5.1 ±8.4; Left ventricular ejection fraction 58±11 %. 86 (42.2 %) patients underwent coronary surgery, 79 (38.7 %) valve surgery, 16 (7.8 %) combined surgery and 23 (11.3 %) others kinds of cardiac surgery. 28 were self-employed (13.7 %). 90 patients were permanent incapacitation for employment after an average of 5.8 months (15 already had permanent incapacity for employment before surgery). Logistic Euroscore was statistically higher in patients than got a permanent incapacity after surgery and they were older with no difference with left ventricular ejection fraction. Women get more permanent incapacity after cardiac surgery but they had more valve surgery. The coronary grafts number, self-employment, as well as valve surgery or valve number operated, were associated with higher total incapacity for employment. Conclusions. Older age, comorbidity, female, to be self-employed and type of intervention were decisive for permanent incapacity for employment. Valve surgery and the number of valves or coronary grafts determine the cumulative probability of permanent incapacity for employment in such patients.