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Trends and Outcomes of Early Rehabilitation in the Intensive Care Unit for Patients With Cardiovascular Disease: A Cohort Study With Propensity Score-Matched Analysis.
Hamazaki, Nobuaki; Kamiya, Kentaro; Nozaki, Kohei; Koike, Tomotaka; Miida, Kazumasa; Yamashita, Masashi; Uchida, Shota; Noda, Takumi; Maekawa, Emi; Yamaoka-Tojo, Minako; Matsunaga, Atsuhiko; Arai, Masayasu; Kitamura, Tadashi; Ako, Junya; Miyaji, Kagami.
Afiliação
  • Hamazaki N; Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Kanagawa, Japan. Electronic address: hamanobu0317@gmail.com.
  • Kamiya K; Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Kanagawa, Japan.
  • Nozaki K; Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Kanagawa, Japan.
  • Koike T; Department of Intensive Care, Kitasato University Hospital, Sagamihara, Kanagawa, Japan.
  • Miida K; Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Kanagawa, Japan.
  • Yamashita M; Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Kanagawa, Japan.
  • Uchida S; Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Kanagawa, Japan.
  • Noda T; Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Kanagawa, Japan.
  • Maekawa E; Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
  • Yamaoka-Tojo M; Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Kanagawa, Japan.
  • Matsunaga A; Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Kanagawa, Japan.
  • Arai M; Department of Anesthesiology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
  • Kitamura T; Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
  • Ako J; Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
  • Miyaji K; Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Heart Lung Circ ; 32(10): 1240-1249, 2023 Oct.
Article em En | MEDLINE | ID: mdl-37634967
ABSTRACT

BACKGROUND:

The effectiveness of acute-phase cardiovascular rehabilitation (CR) in intensive care settings remains unclear in patients with cardiovascular disease (CVD). This study aimed to investigate the trends and outcomes of acute-phase CR in the intensive care unit (ICU) for patients with CVD, including in-hospital and long-term clinical outcomes.

METHOD:

This retrospective cohort study reviewed a total of 1,948 consecutive patients who were admitted to a tertiary academic ICU for CVD treatment and underwent CR during hospitalisation. The endpoints of this study were the following in-hospital

outcomes:

probabilities of walking independence and returning home; and long-term

outcomes:

clinical events 5 years following hospital discharge, including all-cause readmission or cardiovascular events. It evaluated the associations of CR implementation during ICU treatment (ICU-CR) with in-hospital and long-term outcomes using propensity score-matched analysis.

RESULTS:

Among the participants, 1,092 received ICU-CR, the rate of which tended to increase with year trend (p for trend <0.001). After propensity score matching, 758 patients were included for analysis (pairs of n=379 ICU-CR and non-ICU-CR). ICU-CR was significantly associated with higher probabilities of walking independence (rate ratio, 2.04; 95% CI 1.77-2.36) and returning home (rate ratio, 1.22; 95% CI 1.05-1.41). These associations were consistently observed in subgroups aged >65 years, after surgery, emergency, and prolonged ICU stay. ICU-CR showed significantly lower incidences of all-cause (HR 0.71; 95% CI 0.56-0.89) and cardiovascular events (HR 0.69; 95% CI 0.50-0.95) than non-ICU-CR.

CONCLUSIONS:

The implementation of acute-phase CR in ICU increased with year trend, and is considered beneficial to improving in-hospital and long-term outcomes in patients with CVD and various subgroups.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doenças Cardiovasculares Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Heart Lung Circ Assunto da revista: ANGIOLOGIA / CARDIOLOGIA Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doenças Cardiovasculares Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Heart Lung Circ Assunto da revista: ANGIOLOGIA / CARDIOLOGIA Ano de publicação: 2023 Tipo de documento: Article