Maayke Sluman, University of Amsterdam
Maayke Sluman, Bosch
Silke Apers, Katholieke Universiteit Leuven
Judith Sluiter, University of Amsterdam
Karen Nieuwenhuijsen, University of Amsterdam
Philip Moons, Katholieke Universiteit Leuven
Philip Moons, University of Gothenburg
Koen Luyckx, University of the Free State
Koen Luyckx, Katholieke Universiteit Leuven
Adrienne Kovacs, Oregon Health & Science University
Adrienne Kovacs, University Health Network
Corina Thomet, University of Bern
Werner Budts, Katholieke Universiteit Leuven
Junko Enomoto, Department of Adult Congenital Heart Disease Chiba Cardiovascular Center Chiba Japan
Hsiao-Ling Yang, National Taiwan University
Jamie Jackson, Nationwide Children's Hospital
Paul Khairy, Montreal Heart Institute
Stephen Cook, Boston Children's Hospital
Raghavan Subramanyan, National Heart Foundation of Australia
Luis Alday, Division of Cardiology Hospital de Niños Córdoba Argentina
Katrine Eriksen, Oslo University Hospital
Mikael Dellborg, University of Gothenburg
Mikael Dellborg, Sahlgrenska University Hospital
Malin Berghammer, University College West
Malin Berghammer, University of Gothenburg
Eva Mattsson, Karolinska University Hospital
Andrew Mackie, University of Alberta
Samuel Menahem, Monash Medical Center Melbourne Australia
Maryanne Caruana, Mater Dei Hospital
Kathy Gosney, Cincinnati Children's Hospital Medical Center
Alexandra Soufi, Hospital Louis Pradel Lyon France
Susan Fernandes, Lucile Packard Children's Hospital
Kamila White, University of Missouri–St. Louis
Edward Callus, Clinical Psychology Service IRCCS Policlinico San Donato Hospital Milan Italy
Shelby Kutty, University of Nebraska Medical Center
Berto Bouma, University of Amsterdam
Barbara Mulder, University of Amsterdam

Document Type



adult, congenital heart defects, disability, education, employment, work ability


Background: Conflicting results have been reported regarding employment status and work ability in adults with congenital heart disease (CHD). Since this is an impor‐ tant determinant for quality of life, we assessed this in a large international adult CHD cohort. Methods: Data from 4028 adults with CHD (53% women) from 15 different countries were collected by a uniform survey in the cross‐sectional APPROACH International Study. Predictors for employment and work limitations were studied using general linear mixed models. Results: Median age was 32 years (IQR 25‐42) and 94% of patients had at least a high school degree. Overall employment rate was 69%, but varied substantially among countries. Higher education (OR 1.99‐3.69) and having a partner (OR 1.72) were asso‐ ciated with more employment; female sex (OR 0.66, worse NYHA functional class (OR 0.67‐0.13), and a history of congestive heart failure (OR 0.74) were associated with less employment. Limitations at work were reported in 34% and were associated with fe‐ male sex (OR 1.36), increasing age (OR 1.03 per year), more severe CHD (OR 1.31‐2.10), and a history of congestive heart failure (OR 1.57) or mental disorders (OR 2.26). Only a university degree was associated with fewer limitations at work (OR 0.62). Conclusions: There are genuine differences in the impact of CHD on employment status in different countries. Although the majority of adult CHD patients are em‐ ployed, limitations at work are common. Education appears to be the main predictor for successful employment and should therefore be encouraged in patients with CHD.

Publication Date

May 2019

Publication Title

Congenital Heart Disease





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