Emma Thomas1, Mojtaba Lotfaliany1, Sherry L Grace2, Brian Oldenburg1, C Barr Taylor3, David L Hare4,5, Wp Thanuja Rangani1, Ds Anoja F Dheerasinghe1, Dominique A Cadilhac6,7, Adrienne O'Neil1. 1. 1 Melbourne School of Population and Global Health, University of Melbourne, Australia. 2. 2 School of Kinesiology and Health Science, York University, Toronto, Canada. 3. 3 Department of Psychiatry, Stanford and Palo Alto Universities, USA. 4. 4 School of Medicine, University of Melbourne, Australia. 5. 5 Department of Cardiology, Austin Hospital, Australia. 6. 6 School of Clinical Sciences at Monash Health, Monash University, Australia. 7. 7 Florey Institute of Neuroscience and Mental Health, University of Melbourne, Australia.
Abstract
BACKGROUND: Ageing populations and increasing survival following acute coronary syndrome has resulted in large numbers of people living with cardiovascular disease and at high risk of hospitalizations. Rising hospital admissions have a significant financial cost to the healthcare system. AIM: The purpose of this study was to determine whether cardiac rehabilitation is protective against long-term hospital readmission (frequency and length) following acute coronary syndrome. METHODS: Data from 416 Australian patients with acute coronary syndrome enrolled in the Anxiety Depression and heart rate Variability in cardiac patients: Evaluating the impact of Negative emotions on functioning after Twenty four months (ADVENT) prospective cohort study between January 2013-June 2014 was analyzed secondarily. Participants self-reported cardiac rehabilitation attendance over the 12 months post-discharge. All-cause readmission data were extracted from hospital records 24 months post-index event. The association between cardiac rehabilitation and all-cause readmission, frequency of readmissions, and length of stay was assessed using three methods (a) regression analysis, (b) propensity score matching, and (c) inverse probability treatment weighting. RESULTS: Overall, 416 patients consented (53% of eligible patients), of which 414 (99.5%) survived the first 30 days post-discharge and were included in the analysis. Medical records were located for 409 participants after 24 months (98% follow-up rate). In total, 267 (65%) reported attending cardiac rehabilitation; there were 392 readmissions by 239 patients. Cardiac rehabilitation attendance was not associated with all-cause hospital readmission; however, it was associated with lower frequency of hospital admissions (odds ratio 0.53, 95% confidence interval: 0.31-0.91 p-value:0.022) and length of stay (coefficient -1.21 days, 95% confidence interval: -2.46-0.26; marginally significant p-value: 0.055) in adjusted models. CONCLUSION: This study substantiates the long-term benefits of cardiac rehabilitation on readmissions, including length of stay, which would result in lower costs to the healthcare system.
BACKGROUND: Ageing populations and increasing survival following acute coronary syndrome has resulted in large numbers of people living with cardiovascular disease and at high risk of hospitalizations. Rising hospital admissions have a significant financial cost to the healthcare system. AIM: The purpose of this study was to determine whether cardiac rehabilitation is protective against long-term hospital readmission (frequency and length) following acute coronary syndrome. METHODS: Data from 416 Australian patients with acute coronary syndrome enrolled in the Anxiety Depression and heart rate Variability in cardiac patients: Evaluating the impact of Negative emotions on functioning after Twenty four months (ADVENT) prospective cohort study between January 2013-June 2014 was analyzed secondarily. Participants self-reported cardiac rehabilitation attendance over the 12 months post-discharge. All-cause readmission data were extracted from hospital records 24 months post-index event. The association between cardiac rehabilitation and all-cause readmission, frequency of readmissions, and length of stay was assessed using three methods (a) regression analysis, (b) propensity score matching, and (c) inverse probability treatment weighting. RESULTS: Overall, 416 patients consented (53% of eligible patients), of which 414 (99.5%) survived the first 30 days post-discharge and were included in the analysis. Medical records were located for 409 participants after 24 months (98% follow-up rate). In total, 267 (65%) reported attending cardiac rehabilitation; there were 392 readmissions by 239 patients. Cardiac rehabilitation attendance was not associated with all-cause hospital readmission; however, it was associated with lower frequency of hospital admissions (odds ratio 0.53, 95% confidence interval: 0.31-0.91 p-value:0.022) and length of stay (coefficient -1.21 days, 95% confidence interval: -2.46-0.26; marginally significant p-value: 0.055) in adjusted models. CONCLUSION: This study substantiates the long-term benefits of cardiac rehabilitation on readmissions, including length of stay, which would result in lower costs to the healthcare system.
Authors: Jason H Wasfy; Michael K Hidrue; Jacqueline Ngo; Varsha K Tanguturi; Elizabeth T Cafiero-Fonseca; Ryan W Thompson; Natalie Johnson; Susan T McDermott; Jagmeet P Singh; Marcela G Del Carmen; Timothy G Ferris Journal: Circ Cardiovasc Qual Outcomes Date: 2020-05-12