Dynamics of social and labor status in patients undergoing pulmonary thromboendarterectomy

Abstract

Aim. To study the dynamics of social and labor status in patients with chronic thromboembolic pulmonary hypertension (CTEPH) 6 months after pulmonary endarterectomy (PEA) and to identify clinical factors affecting the resumption of labor activity in the late postoperative period.Material and methods. The study included 79 patients with CTEPH scheduled for PEA. The average age was 48.6 (39.3-59.4) years. We analyzed clinical and functional data, as well as social and labor status before and 6 months after PEA. Using multivariate regression analysis, the factors influencing the resumption of labor activity after PEA, were studied.Results. In the general cohort of patients with CTEPH, 6 months after surgery, a slight increase in the proportion of working patients of all ages was revealed - from 55.7% to 65.8% (p=0.19). In the subgroup of patients of working age (61 people), the proportion of working patients in dynamics increased significantly – from 67.2 to 85.2% (p=0.03). Multivariate regression analysis showed a protective effect of the 2nd stage of rehabilitation on social and labor status after PEA – OR 4.2 (2.9-8.3 95%CI) (p=0.01). The presence of atrial fibrillation and residual pulmonary hypertension negatively affected the resumption of labor activity in the long-term period after PEA – OR 0.6 (0.3-0.9 95%CI) (p = 0.03) and OR 0.7 (0.2-0.8 95%CI) (p=0.01) respectively.Conclusion. The dynamics of the social and labor status of patients with CTEPH 6 months after PEA is characterized by a significant increase in the proportion of working patients of working age from 67.2 to 85.2% compared with the preoperative level. The leading protective factor for the renewal of labor potential in patients with CTEPH within 6 months after PEE is the underwenting of the 2nd stage of rehabilitation. Residual pulmonary hypertension and atrial fibrillation are limiting factors for resuming of labor activity.