Soleimani Abbas, Abbasi Ali, Nejatian Mostafa, Salarifar Mojtaba, Darabian Siroos, Karimi Abbas Ali, Davoodi Saeed, Kassaian Seyed Ebrahim, Abbasi Seyed Hesameddin, Sheikhfathollahi Mahmood
Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, P.O. Box: 14155-6559 Tehran, I.R. of Iran.
Kardiol Pol. 2009 Feb;67(2):140-6; discussion 147-8.
Cardiac rehabilitation (CR) programmes play an important role in the management of patients with coronary artery disease. However, a significant proportion of patients do not participate or do not complete CR.
To asses the prevalence and predictors of discontinuation of a hospital-based CR programme and to investigate whether or not the completers and dropouts differed in relation to their baseline characteristics.
Data used for analysis were from a hospital-based CR programme involving 1986 discharged patients at Tehran Heart Centre between July 2004 and January 2006. The patients who completed all 24 sessions of the CR programme were compared with the dropouts.
The CR completion rate was 18.1% (average of 11.4+/-8.1, ranging from 1 to 78 sessions) including patients who completed 24 (n=284) or more sessions (n=77) of the CR programme. Factors predicting dropout were male gender (OR 1.441, p=0.0094), younger age (OR 0.979, p=0.005), and lower levels of education (OR 0.412, p <0.0001).
The present study demonstrated a relatively high rate of CR programme dropout. Only less than a fifth of the patients completed this hospital-based programme. Patients who were male and younger and had lower education levels were better likely to drop out of the CR programme. Social support and educational programmes may be helpful in achieving better compliance.
心脏康复（CR）计划在冠状动脉疾病患者的管理中起着重要作用。然而，相当一部分患者不参与或未完成CR。
评估基于医院的CR计划中断的患病率和预测因素，并调查完成者和退出者在基线特征方面是否存在差异。
用于分析的数据来自于2004年7月至2006年1月德黑兰心脏中心一项涉及1986名出院患者的基于医院的CR计划。将完成CR计划所有24节课程的患者与退出者进行比较。
CR完成率为18.1%（平均11.4±8.1节，范围为1至78节），包括完成24节（n = 284）或更多节（n = 77）CR计划的患者。预测退出的因素为男性（OR 1.441，p = 0.0094）、年龄较小（OR 0.979，p = 0.005）和教育水平较低（OR 0.412，p <0.0001）。
本研究显示CR计划退出率相对较高。只有不到五分之一的患者完成了这个基于医院的计划。男性、年龄较小且教育水平较低的患者更有可能退出CR计划。社会支持和教育计划可能有助于实现更好的依从性。
