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Editorial

Importance of the Correct Definition of Severe Heart Disease in the Prognosis of Individuals Considered with Retirement Due to Disability

Maria Helena Costa de Vasconcelos et al. Andreza Araújo de Oliveira Maria Eduarda da Silva Corrêa João Marcos Bemfica Barbosa Ferreira

The manuscript “The Impact of Severe Heart Disease on Causes of Death and Survival after Disability Retirement” demonstrates higher mortality in individuals retired due to severe heart disease when compared to those retired for other causes or proportional retirement. Furthermore, it showed coinciding diagnoses between the cause of retirement and death in full retirements due to severe heart disease, demonstrating that serious heart disease plays a fundamental role in the prognosis of retired individuals.

In 2006, the Sociedade Brasileira de Cardiologia published the II Brazilian Guideline on Severe Heart Disease, which standardized the classification of heart diseases as serious or not for expert assessment. The manuscript in question, demonstrating the association of the diagnosis of severe heart disease with a worse long-term prognosis, reinforces the need to define the severity of each patient in their assessment correctly.

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Original Article

The Impact of Severe Heart Disease on Causes of Death and Survival after Disability Retirement

Cesar Romaro Pozzobon et al. Gabriel Porto Soares Ronir Raggio Luiz Gláucia Maria Moraes de Oliveira

Abstract

Background:

Noncommunicable diseases contribute to premature deaths and limitations. Disability retirement is linked to chronic conditions, particularly cardiovascular diseases. The II Brazilian Guideline for Severe Heart Disease established criteria for cardiovascular disease classification. However, there is a lack of research in this topic within federal institutions.

Objectives:

Evaluate the survival and causes of death among disabled retirees at UFRJ, focusing on the impact of severe heart disease.

Methods:

A retrospective cohort study based on retirement and death records over 15 years. Retirements were categorized into three groups: full retirement due to severe heart disease, full retirement due to other diseases and proportional. Causes of death were obtained from death certificates. Mortality rates, survival and the presence of matching diagnoses between retirement and death were evaluated. Chi-square, log-rank, Cox models, Kaplan-Meier curves were utilized. Statistical significance with a 95% confidence interval, considering p<0.05.

Results:

There were 630 retirements, 368 (51.4%) in females, with an average age of 52.9 (SD=7.8) years, and 169 (26.8%) deaths. Mortality was higher in professors (37.0%; p=0.113), in the age group between 65 and 70 years (48.4%; p=0.004), in males (34.0%; p=0.001), and in full retirements due to severe heart disease (41.5%; p<0.001). Matching diagnoses between retirement and death were more frequent in professors (74.1%; p=0.026) and in full retirements due to severe heart disease (72.7%; p<0.001).

Conclusions:

Severe heart disease diagnosis is associated with higher mortality and shorter survival in disabled retirees. Its frequent occurrence in retirement and death diagnoses underscores its significance in this context.