Since only half of individuals who had an acute myocardial infarction (AMI) in China return to work a year after hospitalization, reducing in-hospital complications and promoting smoking cessation may be important to increase the likelihood of returning to work, according to a study published Nov. 21 in JAMA Network Open.

Zihan Jiang, MD, et al., sought to assess the rate of returning to work and the factors associated with it within the year after the acute hospital phase of AMI in China. Using data from the China Patient-centered Evaluative Assessment of Cardiac Events Prospective Study of AMI registry, the authors analyzed 1,566 patients in 53 hospitals across China.

Results showed that only 55.9 percent of patients returned to work by 12 months after AMI. Among the patients who did not return, 41.5 percent were unable or preferred not to work because of AMI and 19 percent retired early due to AMI.

Furthermore, the authors found that female sex, a history of smoking and in-hospital complications during the index AMI were associated with a lower likelihood of returning to work. They note that smoking status and in-hospital complications were the only preventable factors associated with a lower likelihood of returning to work.

"Our findings signal the need for interventions that promote a timely return to work after AMI in China to mitigate a preventable decline in the working-age population," the authors write. "Labor-intensive industries are still a vital component of China's economy, and economic growth has relied, at least in part, on the country's high ratio of working-age to non-working-age individuals."

In an accompanying editorial comment, Haider J. Warraich, MD; Tracy Y. Wang, MD, MHS, MSc, FACC; and Robert M. Califf, MD, MACC, comment that studies such as this "emphasize the need to transform the generation of information that can shape policy and medical care." They add, "The development of learning health systems is necessary to develop unique, timely, and actionable knowledge that highlights and addresses issues native to the health ecosystems of countries around the world."

Keywords: Smoking Cessation, Prospective Studies, Return to Work, Economic Development, Registries, Hospitalization, Smoking, Hospitals, Myocardial Infarction, Ecosystem, China

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