Changes in Clinical Characteristics and Outcomes of Patients Admitted to Inpatient Cardiac Rehabilitation

• Published in: International journal of environmental research and public health 2021-08, Vol.18 (16), p.8871
• Main Authors: Costi, Stefania, Tonelli, Roberto, Brogneri, Antonio, Florini, Fabio, Tilocca, Nicolò, Vicentini, Massimo, Baroncini, Serena, Cerulli, Massimo, Clini, Enrico
• Format: Article
• Language: English
• Subjects: Cardiology; Cardiovascular disease; Complications; Coronary artery; Data collection; Dyspnea; Exercise; Fatigue tests; Fitness training programs; Heart; Heart valves; Hospitals; Medical records; Muscle strength; Older people; Patients; Physical fitness; Rehabilitation; Respiration; Surgery
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph18168871

Aims: Cardiac rehabilitation (CR) has proven to be effective and beneficial in middle-aged and older patients. However, solid data in large cohorts of elderly individuals are yet to be explored. This retrospective study investigated the general characteristics, outcomes, and the level of response of patients referred to CR over 13 consecutive years. Methods: We reviewed the medical records of patients admitted to Villa Pineta Rehabilitation Hospital for exercise-based CR from 2006 to 2018. The patients’ baseline characteristics and changes following CR in an upper-limb weightlifting test (ULW), 30-s sit-to-stand test (30STS), and the 6-min walking test (6MWT) with associated Borg-related dyspnea (D) and fatigue (F) were collected. We also calculated the number of individuals that reached the minimal clinically relevant change (MCRC) following CR for each outcome. Results: One thousand five hundred and fifty-one patients (70.2 ± 9.7 years, 66% men) with complete datasets were included in the analysis. Coronary artery bypass graft and cardiac valve replacement surgery were the most frequent surgical procedures leading to CR referral (41.1% and 35.8%, respectively). The patients’ age (p = 0.03), number of total comorbidities (p < 0.0001), and post-surgical complications (p = 0.02) significantly increased over time. In contrast, the average absolute changes in ULW, 30STS, and 6MWT with associated D and F, and the proportion of patients that reached their respective MCRC, remained constant over the same period. Conclusion: The patients admitted to exercise-based CR were older and had more comorbidities and complications over time. The outcomes, however, were not influenced in terms of the absolute change or clinically meaningful response.