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Title: Effect of cardiac rehabilitation on 24-month all-cause hospital readmissions: A prospective cohort study.
Austin Authors: Thomas, Emma;Lotfaliany, Mojtaba;Grace, Sherry L;Oldenburg, Brian;Taylor, C Barr;Hare, David L ;Rangani, Wp Thanuja;Dheerasinghe, Ds Anoja F;Cadilhac, Dominique A;O'Neil, Adrienne
Affiliation: Melbourne School of Population and Global Health, University of Melbourne, Australia
School of Kinesiology and Health Science, York University, Toronto, Canada
Department of Psychiatry, Stanford and Palo Alto Universities, USA
School of Medicine, University of Melbourne, Australia
School of Clinical Sciences at Monash Health, Monash University, Australia
The Florey Institute of Neuroscience and Mental Health
Issue Date: Mar-2019
Date: 2018-12-14
Publication information: European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology 2019; 18(3): 234-244
Abstract: 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. 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. 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. 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. 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.
DOI: 10.1177/1474515118820176
ORCID: 0000-0001-8162-682X
Journal: European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology
PubMed URL: 30547678
Type: Journal Article
Subjects: Cardiac rehabilitation
acute coronary syndrome
hospital readmissions
Appears in Collections:Journal articles

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