Marco Pizzorno1, Manuela Desilvestri1, Lorenzo Lippi2, Manuela Marchioni1, Andrea Audo3, Alessandro de Sire4,5, Marco Invernizzi2, Luca Perrero1. 1. Rehabilitation Unit, Rehabilitation Department, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. 2. Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Viale Piazza D'Armi 1, 28100, Novara, Italy. 3. Department of Cardiothoracic and Vascular Surgery, Cardiac Surgery, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. 4. Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Viale Piazza D'Armi 1, 28100, Novara, Italy. alessandro.desire@gmail.com. 5. Rehabilitation Unit, 'Mons. L. Novarese' Hospital, Moncrivello, Vercelli, Italy. alessandro.desire@gmail.com.
Abstract
BACKGROUND: Cardiac rehabilitation (CR) is considered as a cornerstone in improving physical function in older people after cardiac procedures; however, its effects in patients aged more than 75 years are still debated. AIMS: To assess the effectiveness of early CR in improving functional outcomes and reducing the length of stay (LOS) and sanitary costs in patients aged ≥ 75 years. METHODS: We retrospectively analysed data from medical records of patients aged ≥ 75 years performed CR after cardiac procedures. Patients were divided into two groups according to the median timing lasting from the cardiac procedure and CR start: 'early rehabilitation' (< 8 days) and 'delayed rehabilitation' (≥ 8 days). Six-minutes walking test (6MWT), left ventricular ejection fraction (LVEF), LOS, and sanitary costs were assessed. RESULTS: The 160 patients (mean aged 79.18 ± 3.13 years) included were divided into two groups: 'early rehabilitation' (n = 80) and 'delayed rehabilitation' (n = 80). Both groups showed a significant improvement (p < 0.0001) in 6MWT and LVEF but there were no differences between groups in all clinical outcomes. On the other hand, the 'early rehabilitation' group showed significantly lower LOS (25.8 ± 5.3 vs 34.1 ± 10.8 days; p < 0.0001) and sanitary costs (22,282.08 ± 3242.68 euros vs. 44,954.03 ± 22,160.11 euros; p < 0.0001). DISCUSSION: Beginning CR in the first week seems to be effective in improving physical performance after cardiac procedures in patients aged ≥ 75 years, reducing LOS and sanitary costs. CONCLUSIONS: Our findings suggest that early CR could be performed with positive effects on functional outcomes, leading to a reduction in LOS and sanitary costs in elderly.
BACKGROUND: Cardiac rehabilitation (CR) is considered as a cornerstone in improving physical function in older people after cardiac procedures; however, its effects in patients aged more than 75 years are still debated. AIMS: To assess the effectiveness of early CR in improving functional outcomes and reducing the length of stay (LOS) and sanitary costs in patients aged ≥ 75 years. METHODS: We retrospectively analysed data from medical records of patients aged ≥ 75 years performed CR after cardiac procedures. Patients were divided into two groups according to the median timing lasting from the cardiac procedure and CR start: 'early rehabilitation' (< 8 days) and 'delayed rehabilitation' (≥ 8 days). Six-minutes walking test (6MWT), left ventricular ejection fraction (LVEF), LOS, and sanitary costs were assessed. RESULTS: The 160 patients (mean aged 79.18 ± 3.13 years) included were divided into two groups: 'early rehabilitation' (n = 80) and 'delayed rehabilitation' (n = 80). Both groups showed a significant improvement (p < 0.0001) in 6MWT and LVEF but there were no differences between groups in all clinical outcomes. On the other hand, the 'early rehabilitation' group showed significantly lower LOS (25.8 ± 5.3 vs 34.1 ± 10.8 days; p < 0.0001) and sanitary costs (22,282.08 ± 3242.68 euros vs. 44,954.03 ± 22,160.11 euros; p < 0.0001). DISCUSSION: Beginning CR in the first week seems to be effective in improving physical performance after cardiac procedures in patients aged ≥ 75 years, reducing LOS and sanitary costs. CONCLUSIONS: Our findings suggest that early CR could be performed with positive effects on functional outcomes, leading to a reduction in LOS and sanitary costs in elderly.
Authors: M Massucci; L Perrero; E Mantellini; S Petrozzino; F Gamna; A Nocella; F Sciarrini; R Antenucci; D Bonaiuti Journal: Eur J Phys Rehabil Med Date: 2011-10-26 Impact factor: 2.874
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Authors: Paul Keessen; Ingrid Cd van Duijvenbode; Corine Hm Latour; Roderik A Kraaijenhagen; Veronica R Janssen; Harald T Jørstad; Wilma Jm Scholte Op Reimer; Bart Visser Journal: JMIR Cardio Date: 2022-05-25