International journal of general medicine · 2026
Return to Work Status and Influencing Factors Among Young and Middle-Aged Patients with Stanford Type A Aortic Dissection After Cardiac Surgery: A Random Forest Model Analysis.
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Chen Siyin, Huang Yingwen, Cheng Yunqing, Chen Hanxi, You Tianhui
Аннотация
PURPOSE: To investigate the current status of return to work (RTW) and its influencing factors among young and middle-aged patients with Stanford Type A aortic dissection (STAAD) after cardiac surgery.
METHODS: A cross-sectional study was conducted, encompassing a sample of 208 participants who underwent cardiac surgery for STAAD in Guangdong Provincial People's Hospital from July 2024 to August 2025. All participants completed a general information questionnaire, Return-to-Work Self-Efficacy Questionnaire, Hospital Anxiety and Depression Scale, Brief Illness Perception Questionnaire, and Social Support Rating Scale. Univariate analyses, binary logistic regression analyses, and a random forest model (RFM) were used to identify independent factors influencing RTW.
RESULTS: A total of 208 participants completed the assessment, with only 82 (39.4%) returning to work. Binary logistic regression analysis revealed that being the primary household breadwinner (OR = 4.79, 95% CI: 1.70-13.51), performing non-manual work (OR = 3.96, 95% CI: 1.34-11.73), objective support (OR = 1.48, 95% CI: 1.03-2.11), subjective support (OR = 1.54, 95% CI: 1.04-2.30), return-to-work self-efficacy (OR = 10.68, 95% CI: 4.21-27.13) and NYHA functional class III (OR = 0.155, 95% CI: 0.03-0.77) were independent factors influencing RTW in young and middle-aged STAAD patients after cardiac surgery (all P < 0.05). The variable importance ranking for the RFM is as follows: return to work self-efficacy, objective support, subjective support, NYHA functional class, primary household breadwinner, and nature of work.
CONCLUSION: RTW rate among young and middle-aged STAAD patients following cardiac surgery remains low. Early identification of high-risk individuals is crucial for clinical care and rehabilitation planning. These findings provide a basis for developing targeted multidisciplinary rehabilitation strategies aimed at improving outcomes for vocational reintegration.
METHODS: A cross-sectional study was conducted, encompassing a sample of 208 participants who underwent cardiac surgery for STAAD in Guangdong Provincial People's Hospital from July 2024 to August 2025. All participants completed a general information questionnaire, Return-to-Work Self-Efficacy Questionnaire, Hospital Anxiety and Depression Scale, Brief Illness Perception Questionnaire, and Social Support Rating Scale. Univariate analyses, binary logistic regression analyses, and a random forest model (RFM) were used to identify independent factors influencing RTW.
RESULTS: A total of 208 participants completed the assessment, with only 82 (39.4%) returning to work. Binary logistic regression analysis revealed that being the primary household breadwinner (OR = 4.79, 95% CI: 1.70-13.51), performing non-manual work (OR = 3.96, 95% CI: 1.34-11.73), objective support (OR = 1.48, 95% CI: 1.03-2.11), subjective support (OR = 1.54, 95% CI: 1.04-2.30), return-to-work self-efficacy (OR = 10.68, 95% CI: 4.21-27.13) and NYHA functional class III (OR = 0.155, 95% CI: 0.03-0.77) were independent factors influencing RTW in young and middle-aged STAAD patients after cardiac surgery (all P < 0.05). The variable importance ranking for the RFM is as follows: return to work self-efficacy, objective support, subjective support, NYHA functional class, primary household breadwinner, and nature of work.
CONCLUSION: RTW rate among young and middle-aged STAAD patients following cardiac surgery remains low. Early identification of high-risk individuals is crucial for clinical care and rehabilitation planning. These findings provide a basis for developing targeted multidisciplinary rehabilitation strategies aimed at improving outcomes for vocational reintegration.