Document Detail

Inpatient cardiac rehabilitation soon after hospitalization for acute decompensated heart failure: a propensity score study.
MedLine Citation:
PMID:  22193932     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Postdischarge management of acute decompensated heart failure (ADHF) remains an ongoing challenge. We sought to assess whether inpatient cardiac rehabilitation (CR) soon after hospitalization for ADHF improves outcome.
METHODS: Patients (N = 275) hospitalized for ADHF were enrolled. The primary outcome was a composite of all-cause mortality and urgent heart transplantation (UHT) at 1 year. The followup started at the time of discharge from the acute care setting. Because of the observational nature of the study, a propensity score analysis was used to predict the likelihood of undergoing CR. A multivariable Cox regression analysis adjusted for propensity score was used to assess the effect of CR on the primary outcome.
RESULTS: Of the 275 patients, 130 underwent CR. Among the baseline variables of the index hospitalization for ADHF, propensity score derivation identified male gender, New York Heart Association Class IV, refractory HF, moderate to severe mitral or tricuspid regurgitation, nonuse of renin-angiotensin-aldosterone system inhibitors, and daily dosage of furosemide, as being independently associated with the likelihood of undergoing CR. No patient was lost to followup. During the 12-month followup, 74 patients died and 3 underwent UHT. The overall incidence of the primary outcome was 28%. On propensity score-adjusted Cox multivariable analysis, the relative risk of the primary outcome for participants in CR compared with nonparticipants in CR was 0.58 (confidence interval [CI]: 0.34-0.99; P = .04).
CONCLUSIONS: Results suggest that the strategy of inpatient CR soon after discharge from the acute care setting improves 1-year UHT-free survival of patients with ADHF.
Domenico Scrutinio; Andrea Passantino; Raffaella Catanzaro; Giuseppe Farinola; Rocco Lagioia; Filippo Mastropasqua; Antonio Ricci; Daniela Santoro
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiopulmonary rehabilitation and prevention     Volume:  32     ISSN:  1932-751X     ISO Abbreviation:  J Cardiopulm Rehabil Prev     Publication Date:    2012 Mar-Apr
Date Detail:
Created Date:  2012-03-01     Completed Date:  2012-07-10     Revised Date:  2012-09-04    
Medline Journal Info:
Nlm Unique ID:  101291247     Medline TA:  J Cardiopulm Rehabil Prev     Country:  United States    
Other Details:
Languages:  eng     Pagination:  71-7     Citation Subset:  IM    
Division of Cardiology and Cardiac Rehabilitation, S. Maugeri Foundation, IRCCS, Institute of Cassano Murge, Bari, Italy.
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MeSH Terms
Confidence Intervals
Continuity of Patient Care
Coronary Artery Disease / mortality,  rehabilitation*
Heart Failure / mortality,  rehabilitation*
Multivariate Analysis
Patient Discharge
Propensity Score
Risk Factors
Statistics as Topic
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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