Functional outcomes of patients on a rehabilitation unit after open heart surgery.

BACKGROUND: Compared with predecessors, the modern-day patient who undergoes cardiac surgery is sicker, is older, has more diffuse disease, has poorer ventricular function, and is more likely to be a repeat surgery. Patients hospitalized after open heart surgery in the 1990s, therefore, may require increasingly comprehensive rehabilitation services before returning to the community; however, information documenting functional progress during, and outcome after, a hospital-based rehabilitation program is scarce.
METHODS: During a 14-month period, a consecutive sample of 44 patients who underwent cardiac surgery and were admitted to a rehabilitation unit in a tertiary acute hospital was studied. Thirty-one patients had coronary artery bypass graft, six had valvular surgery, and seven had both. Each patient's functional status on admission and discharge from the rehabilitation unit was assessed using the Functional Independence Measure. Other data studied included patient age and sex, premorbid medical problems, type of cardiac surgery, length of stay, and occurrence of medical complications in the acute and rehabilitation units.
RESULTS: The mean Functional Independence Measure scores at rehabilitation unit admission and discharge were 76.1 +/- 17.1 and 96.7 +/- 19.4, respectively, and this difference was significant (P < 0.0001). The most significant correlates (alpha = 0.05) of the discharge Functional Independence Measure were admission Functional Independence Measure (P < 0.00001) and length of stay in the acute care unit (P = 0.0072). Age and presence of medical complications were not significant.
CONCLUSION: Patients who undergo open heart surgery, many of whom have medical comorbidity, are able to demonstrate substantial functional improvement on an inpatient rehabilitation program before hospital discharge.