Key result
CR shows consistent functional improvements over 13 years despite older patients with more comorbidities.
Why the study?
Solid data on clinical characteristics and outcomes of elderly patients undergoing exercise-based cardiac rehabilitation in large cohorts are lacking.
Does exercise-based cardiac rehabilitation improve functional outcomes in patients despite increasing age and comorbidities over time?
Observational (n=1,551)
No
Does exercise-based cardiac rehabilitation improve functional outcomes in patients despite increasing age and comorbidities over time?
Exercise-based cardiac rehabilitation remains consistently effective in improving functional capacity despite a trend toward older and more comorbid patient populations over time.
Increasing age/comorbidities in CR referrals did not reduce functional gains; leaves open whether benefits extend to unselected elderly populations.
Aims: Cardiac rehabilitation (CR) has proven to be effective and beneficial in middle-aged and older patients. However, solid data in large cohorts of elderly individuals are yet to be explored. This retrospective study investigated the general characteristics, outcomes, and the level of response of patients referred to CR over 13 consecutive years. Methods: We reviewed the medical records of patients admitted to Villa Pineta Rehabilitation Hospital for exercise-based CR from 2006 to 2018. The patients’ baseline characteristics and changes following CR in an upper-limb weightlifting test (ULW), 30-s sit-to-stand test (30STS), and the 6-min walking test (6MWT) with associated Borg-related dyspnea (D) and fatigue (F) were collected. We also calculated the number of individuals that reached the minimal clinically relevant change (MCRC) following CR for each outcome. Results: One thousand five hundred and fifty-one patients (70.2 ± 9.7 years, 66% men) with complete datasets were included in the analysis. Coronary artery bypass graft and cardiac valve replacement surgery were the most frequent surgical procedures leading to CR referral (41.1% and 35.8%, respectively). The patients’ age (p = 0.03), number of total comorbidities (p < 0.0001), and post-surgical complications (p = 0.02) significantly increased over time. In contrast, the average absolute changes in ULW, 30STS, and 6MWT with associated D and F, and the proportion of patients that reached their respective MCRC, remained constant over the same period. Conclusion: The patients admitted to exercise-based CR were older and had more comorbidities and complications over time. The outcomes, however, were not influenced in terms of the absolute change or clinically meaningful response.
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Costi et al. (2021) conducted an observational in Cardiac rehabilitation (n=1,551). Exercise-based cardiac rehabilitation was evaluated on Changes in upper-limb weightlifting test, 30-s sit-to-stand test, and 6-min walking test with associated dyspnea and fatigue, and proportion reaching minimal clinically relevant change. Despite patients admitted to cardiac rehabilitation becoming older with more comorbidities over 13 years, their functional improvements and clinically meaningful responses remained constant.
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