Key result
Cardiac rehabilitation following cardiac surgery did not significantly improve physical or mental health-related quality of life at 180 days compared to non-participation.
Why the study?
Cardiac surgery often results in perioperative loss of health-related quality of life, but the role of cardiac rehabilitation on quality of life in this specific population remains unclear.
Does cardiac rehabilitation improve health-related quality of life in cardiac surgery patients?
Observational (n=218)
No
Does cardiac rehabilitation improve health-related quality of life in cardiac surgery patients?
Absolute Event Rate: 47.36% vs 46.67%
p-value: p=0.617
Cardiac rehabilitation did not significantly improve health-related quality of life compared to non-participation in cardiac surgery patients, though both groups improved from baseline, highlighting the need to address significant barriers to CR uptake.
BACKGROUND: Undergoing cardiac surgery often result in perioperative loss of health-related quality of life (HRQOL). Although participation rates in Australia is low, cardiac rehabilitation (CR) has been demonstrated to improve patient HRQOL in cardiac patients. Literature is unclear regarding the role of CR and HRQOL in the cardiac surgery (CS) patient population. METHODS: A prospective non-randomised study was conducted on eligible cardiac surgery patients between December 2009 and March 2015. HRQOL was assessed using the Short Form 12 at baseline and post-operatively at 30 days and 180 days. CR participation was recorded and barriers to CR uptake was assessed using the Cardiac Rehabilitation Enrolment Obstacles (CREO) scale. RESULTS: At 180 days, 107 patients participated in CR and 111 did not participate in CR. A significant improvement from baseline mental and physical HRQOL was observed in both groups at 30 days and 180 days (p < 0.002). No significant difference between group characteristics or HRQOL was observed at any time. A trend of superior improvement in mental QOL was observed in the CR group. The study is limited by poor initial uptake (218/1772 of eligible) and may be underpowered to observe a clinical difference. A significant difference in CREO scores were observed between the two groups at 30 days (13 out of 16 questions, p < 0.001) and 180 days (11 out of 16 questions, p < 0.011). CONCLUSION: Literature has shown that CR may improve numerous health outcomes in cardiac and CS patients, however CR uptake in Australia is low. Mental and Physical QOL is demonstrated to improve following CS, however further research is required to delineate the role of CR and QOL in CS patients. The CREO tool utilised in this study identified numerous potentially modifiable barriers to CR uptake. Specific strategies related to the survey are suggested to improve awareness, uptake, and adherence to CR, including advocacy of home-based and telehealth services.
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Lourens et al. (2022) conducted an observational in Cardiac surgery (n=218). Cardiac rehabilitation vs. Non-cardiac rehabilitation was evaluated on Physical health-related quality of life (SF12 score) at 180 days (p=0.617). Cardiac rehabilitation following cardiac surgery did not significantly improve physical or mental health-related quality of life at 180 days compared to non-participation.
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