Efficacy of Early Cardiac Rehabilitation After Cardiac Surgery　- Verification Using Japanese Diagnosis Procedure...

Area of Science:

• Cardiology
• Rehabilitation Medicine
• Health Services Research

Background:

• The adoption and effectiveness of early cardiac rehabilitation (E-CR) post-cardiac surgery in Japan remain unclear.
• Understanding the current landscape of E-CR is crucial for improving patient recovery and outcomes.

Purpose of the Study:

• To investigate the current status and efficacy of early cardiac rehabilitation (E-CR) following cardiac surgery in Japan.
• To analyze the impact of E-CR on clinical outcomes using a large patient dataset.

Main Methods:

• Analysis of 220,122 patients undergoing major cardiac and thoracic vascular surgery from April 2012 to March 2018, using the Diagnosis Procedure Combination (DPC) database.
• Definition of E-CR as rehabilitation starting within 1 day post-surgery.
• Propensity score matching to compare clinical outcomes between patients with and without E-CR.

Main Results:

• E-CR was initiated in 47.4% to 56.9% of patients across different cardiovascular surgery types.
• Propensity score-matched analysis revealed significantly superior outcomes for E-CR, including reduced in-hospital deaths.
• E-CR was associated with improved Barthel Index scores at discharge, shorter hospital stays, and lower hospitalization costs.

Conclusions:

• Early cardiac rehabilitation (E-CR) following cardiac surgery demonstrates significant benefits for patient prognosis, hospital stay duration, and medical costs.
• This large-scale data analysis provides the first evidence in Japan supporting the effectiveness of E-CR.
• Widespread recommendation and implementation of E-CR are encouraged for future cardiac surgery patient care.