Incapacidad laboral permanente en pacientes menores de 62 años sometidos a cardiocirugía abierta. Estudio monocéntrico de un trieno / Permanent incapacity for employment on patients younger than 62 years old underwent cardiac surgery. Single centre 3 years study

Introducción y objetivos: Aunque tras la cirugía cardiaca abierta la calidad de vida mejora, la reinserción laboral no siempre es posible. Nuestro objetivo es identificar cuando es más frecuente la incapacidad laboral permanente tras la cirugía y cuáles son los factores predisponentes. Métodos: Los 204 menores de 62 años intervenidos de cirugía cardiaca entre 2010 y 2012 se estudiaron pre y postoperatoriamente. Resultados: Edad media 51±9 años, 156 (76,5%) varones, Euroscore Logístico 5,1±8,4; fracción de eyección ventricular izquierda 58±11%; 86 (42,2%) coronarios, 79 (38,7%) valvulares, 16 (7,8%) cirugías combinadas y 23 (11,3%) otras. Trabajadores autónomos 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 tenían al operarse). Los pacientes que obtuvieron la incapacidad laboral permanente presentaban, de forma estadísticamente significativa, un Euroscore mayor y mayor edad; sin diferencias en la fracción de eyección. Entre mujeres hubo más incapacidad laboral permanente y estando en incapacidad laboral permanente, más con cirugía valvular 67% que otra cirugía, p=0,013. Mayor número de puentes, ser trabajador autónomo o ser intervenido de alguna válvula, así como el número de válvulas intervenidas, se asoció a más incapacidad laboral permanente. Conclusiones: La edad, comorbilidad, sexo femenino, ser trabajador autónomo y el tipo de intervención fueron predictores para la incapacidad laboral permanente tras la cirugía cardiaca. La cirugía valvular, el número de válvulas y el de puentes coronarios determinan en mayor grado la probabilidad acumulada de incapacidad laboral permanente

Introduction 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

A national programme for patient and staff dose monitoring in interventional cardiology.

A national programme on patient and staff dose evaluation in interventional cardiology made in cooperation with the haemodynamic section of the Spanish Society of Cardiology has recently been launched. Its aim is to propose a set of national diagnostic reference levels (DRLs) for patients as recommended by the International Commission on Radiological Protection and to initiate several optimisation actions to improve radiological protection of both patients and staff. Six hospitals have joined the programme and accepted to submit their data to a central database. First to be acquired were the quality control data of the X-ray systems and radiation doses of patients and professionals. The results from 9 X-ray systems, 1467 procedures and staff doses from 43 professionals were gathered. Provisional DRLs resulted in 44 Gy cm(2) for coronary angiography and 78 Gy cm(2) for interventions. The X-ray systems varied up to a factor of 5 for dose rates in reference conditions. Staff doses showed that 50 % of interventional cardiologists do not use their personal dosemeters correctly.