Return to Work After Type A Aortic Dissection

Objective Acute type A aortic dissection (TAAD) frequently affects patients during working years, but patient-centered employment outcomes after operative repair are not well characterized. The aim of this study was to describe return-to-work and self-reported income loss among 30-day survivors using a voluntary survey within a dual-center, single health system. Methods After Institutional Review Board (IRB) approval, we conducted a retrospective review of a prospectively maintained database and included any patient who suffered an acute type A aortic dissection that was treated operatively. We analyzed those who survived beyond 30 days. We subsequently contacted each of these patients to enroll them in a voluntary survey to assess their pre-operative and post-operative occupation, associated salary, and loss thereof from their recovery and perioperative period. Statistical analysis was then performed. Results A total of 173 patients who underwent urgent or emergent repair of TAAD from 2012 to 2023 were identified, and an attempt to contact each of them was made. Out of 173 patients surveyed, 49 were willing to participate in the survey. Out of 49 surveys collected, 22 were not filled out completely and were therefore excluded from the study, leaving 27 completed surveys. The mean number of missed working days as a result of undergoing surgical intervention was 103 days, and the average amount of direct missed income was $3347.22 per patient. Additionally, only 62.9% (17 out of 27) of patients returned to full- or part-time work after aortic surgery. In an exploratory stratification by annual income (<$40,000 vs ≥$40,000), return-to-work was two of six (33.3%) versus 15 of 21 (71.4%), respectively; this comparison was underpowered and not statistically significant. Conclusions Among survey respondents, prolonged time away from work after operative repair of TAAD was common, and a substantial proportion did not return to work. Because the respondent cohort was small and selected, these findings should be interpreted as descriptive and hypothesis-generating. Larger prospective studies are needed to evaluate predictors of return-to-work and to assess whether structured rehabilitation and survivorship support improve vocational recovery.