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Effect of Early Rehabilitation on Physical Function in Patients Undergoing Coronary Artery Bypass Grafting: A

Hiroyuki Ohbe1, Kensuke Nakamura2, Kazuaki Uda1

  • 1Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1130033, Japan.

Journal of Clinical Medicine
|February 10, 2021
PubMed

Insights

Starting rehabilitation within 3 days of coronary artery bypass grafting (CABG) in the intensive care unit (ICU) improves patient outcomes. Early rehabilitation enhances physical function and reduces mortality, costs, and length of stay.

Area of Science:

  • Cardiology
  • Intensive Care Medicine
  • Rehabilitation Medicine

Background:

  • Timing of rehabilitation after coronary artery bypass grafting (CABG) in the intensive care unit (ICU) is not well-defined.
  • Early mobilization and rehabilitation are crucial for recovery after major surgery.

Purpose of the Study:

  • To investigate the impact of early rehabilitation initiation within 3 days of CABG on patient outcomes.
  • To compare functional status, mortality, and resource utilization between early and usual care rehabilitation groups.

Main Methods:

  • Retrospective analysis of the Japanese Diagnosis Procedure Combination inpatient database (2010-2018).
  • Inclusion of adult patients undergoing CABG and admitted to ICU for ≥3 days.
  • Definition of early rehabilitation as initiation within 3 days of CABG; usual care as later initiation.
  • Application of inverse probability of treatment weighting (IPTW) for comparative analysis.

Main Results:

  • 30,568 eligible patients identified; 43% received early rehabilitation.
  • Early rehabilitation group showed significantly higher Barthel Index scores at discharge (difference: 3.2; 95% CI: 1.5-4.8).
  • Early rehabilitation was associated with significantly lower in-hospital mortality, total hospitalization costs, ICU length of stay, and overall hospital stay.

Conclusions:

  • Initiating rehabilitation within 3 days of CABG is safe and feasible.
  • Early rehabilitation improves physical function and reduces adverse outcomes post-CABG.
  • This approach optimizes resource utilization and patient recovery in the ICU setting.

Keywords:
coronary artery bypass graftingintensive care unitobservational studyphysical impairmentspost-intensive care syndromerehabilitation

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