Key result
Early post-CABG rehabilitation linked to a 3.2-point higher discharge Barthel Index versus usual care.
Why the study?
It is unclear when to begin rehabilitation after CABG in the intensive care unit.
Does early rehabilitation within 3 days of CABG improve physical function at discharge in adult patients admitted to the ICU for ≥3 days?
Cohort (n=30,568)
Yes
Does early rehabilitation within 3 days of CABG improve physical function at discharge in adult patients admitted to the ICU for ≥3 days?
Early rehabilitation initiated within 3 days of CABG in ICU patients is associated with improved physical function at discharge, lower in-hospital mortality, and reduced hospital length of stay and costs.
May support early post-CABG rehab for function; leaves open causal confirmation in RCTs before practice change.
It is unclear when to begin rehabilitation after coronary artery bypass grafting (CABG) in the intensive care unit (ICU). Using the Japanese Diagnosis Procedure Combination inpatient database from 2010 to 2018, we identified adult patients who underwent a CABG and who were admitted to the ICU for ≥3 consecutive days from the date of their CABG. Patients who started any rehabilitation program prescribed by physicians or therapists within 3 days of CABG were defined as the early rehabilitation group, and the remaining patients were defined as the usual care group. We identified 30,568 eligible patients, with 13,150 (43%) patients in the early rehabilitation group. An inverse probability of treatment weighting analyses showed that the Barthel Index score at discharge in the early rehabilitation group was significantly higher than that in the usual care group (difference: 3.2; 95% confidence interval: 1.5-4.8). The early rehabilitation group had significantly lower in-hospital mortality, total hospitalization costs, length of ICU stay, and hospital stay vs. the usual care group. Our results suggested that early rehabilitation by physicians or therapists beginning within 3 days of CABG was safe, as suggested by the low mortality and improved physical function in patients who underwent CABG.
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Ohbe et al. (2021) conducted a cohort in Coronary artery bypass grafting (n=30,568). Early rehabilitation within 3 days of CABG vs. Usual care was evaluated on Barthel Index score at discharge (Difference 3.2, 95% CI 1.5-4.8). Early rehabilitation within 3 days of CABG significantly improved the Barthel Index score at discharge compared to usual care (difference: 3.2; 95% CI: 1.5-4.8).
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