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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program

A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program

Published on: April 19, 2019

Changes in risk factors and exercise capacity after cardiac rehabilitation and its effect on hospital readmission

Farid Najafi¹, Mehdi Nalini², Mohammad Reza Nikbakht³

¹Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, IR Iran.

Iranian Red Crescent Medical Journal

|July 18, 2014

Insights

Cardiac rehabilitation (CR) significantly improves cardiovascular risk factors and exercise capacity in patients. However, female patients and those with a history of diabetes face higher re-admission risks.

Area of Science:

Cardiology
Preventive Medicine
Rehabilitation Medicine

Background:

Cardiac rehabilitation (CR) programs show varied impacts globally, potentially due to differing program structures.
Understanding the effectiveness of specific CR programs is crucial for optimizing patient outcomes.

Purpose of the Study:

To evaluate the impact of a comprehensive cardiac rehabilitation program on cardiovascular risk factors.
To identify factors associated with hospital re-admission and mortality post-cardiac rehabilitation.

Main Methods:

Retrospective cohort study analyzing data from 499 patients at Imam Ali Cardiac Rehabilitation Center (2001-2008).
Statistical analyses included paired t-tests, logistic regression, and univariate Cox proportional hazard models.
Outcomes assessed were changes in cardiovascular risk factors, re-admission rates, and survival.

Main Results:

Significant improvements were observed in anthropometric measurements, blood lipids (excluding HDL), blood pressure, depression, anxiety, and exercise capacity (P < 0.05).
Female sex (OR=2.40) and diabetes history (OR=2.04) were significant predictors of re-admission.
Higher initial anthropometric measurements and lower exercise capacity were associated with re-admission; survival rate was high (97.5%) with no significant predictors of mortality.

Conclusions:

The cardiac rehabilitation program at Imam Ali Center effectively reduces cardiovascular risk factors and enhances exercise capacity.
Identifying high-risk patients for re-admission, such as females and those with diabetes, allows for targeted interventions.

Read full analysis

Abstract

Background:

Despite the positive outcomes reported with cardiac rehabilitation (CR), its impacts have been reported to be different from a region or country to another, which may be due to the different contents of rehabilitation programs.

Objectives:

To investigate the effect of CR on cardiovascular risk factors.

Patients And Methods:

This is a retrospective cohort study on the data from Imam Ali Cardiac Rehabilitation Center in Kermanshah province, Iran from 2001 to 2008. We used paired t-test to evaluate the effect of CR on cardiovascular risk factors. Logistic regression or t-test (unequal variance) were used to assess the factors influencing re-admission (due to cardiac problems). The relationship between different variables and death was studied using univariate cox proportional hazard. P values < 0.05 were considered significant for all analyses.

Results:

Out of 504 patients who completed rehabilitation, a total of 499 were analyzed. These 499 patients consisted of 383 men and 116 women. All anthropometric measurements, blood lipids (except HDL cholesterol), systolic and diastolic blood pressure, depression, anxiety and exercise capacity improved after rehabilitation (P < 0.05 for all cases). The improvement was observed in both sexes. A total of 39 patients were re-admitted to hospital after rehabilitation. Being female (OR = 2.40; 95%CI: 1.22-4.68) and history of diabetes (OR = 2.04; 95%CI: 1.04-4.02) increased the risk of re-admission significantly. Patients who were readmitted had higher anthropometric measurements at the beginning and the end of the program. Moreover, the initial exercise capacity of readmitted patients was lower than those who were not readmitted. After a maximal follow-up period of 6.3 years (median = 2.99 years), only eight patients expired (survival rate: 97.5%; 95%CI: 94.7-98.8). None of the variables in our study was significantly related to the survival rate.

Conclusions:

The comprehensive CR program in Imam Ali Center efficiently reduces cardiovascular risk factors and improves exercise capacity.

Keywords:

Exercise Tolerance Patient Readmission Rehabilitation Risk Factors

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