Should airline pilots be eligible to resume active flight status after coronary bypass surgery? A CASS registry study

Coronary Artery Surgery Study

Research output: Contribution to journalEditorial

6 Citations (Scopus)

Abstract

Medical certification to return to work after coronary bypass surgery in occupations that carry a risk to public safety is controversial, particularly for airline pilots. To address this issue, 10,312 patients from the CASS registry who underwent coronary bypass surgery were studied and 2,326 men with clinical and postoperative characteristics similar to those of the average airline pilot who might apply to renew his license after surgery were selected. The 5 year probability of remaining free of an acute cardiac event, defined as acute coronary insufficiency, myocardial infarction or sudden death, was 0.92 ± 0.01 (mean ± SE) for the 1,207 men without previous myocardial infarction and 0.98 ± 0.01 for the 122 men who never smoked and did not have a history of hypertension. Among the 1,119 men with a previous myocardial infarction, the probability of remaining free of acute cardiac events was 0.91 ± 0.02 and 0.92 ± 0.02 when left ventricular contraction score was 5 to 9 and 10 or greater, respectively. In this patient subgroup, mortality rate was similar to that of the age-matched U.S. male population when the left ventricular contraction score was 5 to 9 (4.0% versus 4.3%; p = NS) but significantly worse when the left ventricular contraction score was 10 or greater (7% versus 4.2%; p = 0.05). The data from this CASS registry study are pertinent to the question of operationally unlimited first-class medical certification of carefully selected airline pilots after coronary bypass surgery. The data are also relevant to the issue of medical certification after coronary bypass surgery for individuals in other occupations in the transportation industry where public safety is an issue.

Original languageEnglish (US)
Pages (from-to)1318-1324
Number of pages7
JournalJournal of the American College of Cardiology
Volume8
Issue number6
DOIs
StatePublished - Jan 1 1986
Externally publishedYes

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Registries
Certification
Myocardial Infarction
Occupations
Safety
Return to Work
Licensure
Sudden Death
Industry
Pilots
6-chloropenicillanic acid S-sulfoxide
Hypertension
Mortality
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Should airline pilots be eligible to resume active flight status after coronary bypass surgery? A CASS registry study. / Coronary Artery Surgery Study.

In: Journal of the American College of Cardiology, Vol. 8, No. 6, 01.01.1986, p. 1318-1324.

Research output: Contribution to journalEditorial

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abstract = "Medical certification to return to work after coronary bypass surgery in occupations that carry a risk to public safety is controversial, particularly for airline pilots. To address this issue, 10,312 patients from the CASS registry who underwent coronary bypass surgery were studied and 2,326 men with clinical and postoperative characteristics similar to those of the average airline pilot who might apply to renew his license after surgery were selected. The 5 year probability of remaining free of an acute cardiac event, defined as acute coronary insufficiency, myocardial infarction or sudden death, was 0.92 ± 0.01 (mean ± SE) for the 1,207 men without previous myocardial infarction and 0.98 ± 0.01 for the 122 men who never smoked and did not have a history of hypertension. Among the 1,119 men with a previous myocardial infarction, the probability of remaining free of acute cardiac events was 0.91 ± 0.02 and 0.92 ± 0.02 when left ventricular contraction score was 5 to 9 and 10 or greater, respectively. In this patient subgroup, mortality rate was similar to that of the age-matched U.S. male population when the left ventricular contraction score was 5 to 9 (4.0{\%} versus 4.3{\%}; p = NS) but significantly worse when the left ventricular contraction score was 10 or greater (7{\%} versus 4.2{\%}; p = 0.05). The data from this CASS registry study are pertinent to the question of operationally unlimited first-class medical certification of carefully selected airline pilots after coronary bypass surgery. The data are also relevant to the issue of medical certification after coronary bypass surgery for individuals in other occupations in the transportation industry where public safety is an issue.",
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