Pérez Lopez Jorge, Negrón Jesús, Soltero Ernesto, Oms Rafael, Magraner Miguel, Bredy Rafael
Physical Medicine and Rehabilitation Department, Baylor School of Medicine, Houston, Texas, USA.
Bol Asoc Med P R. 2011 Apr-Jun;103(2):6-13.
Patients with coronary artery disease (CAD) or cardiac valve disease who have undergone cardiac surgery are prime candidates for cardiac rehabilitation. Cardiac rehabilitation is a multidisciplinary activity that aims to facilitate physical, psychological and emotional recovery. Multiple studies have evaluated preoperative characteristics of patients who undergo rehabilitation to predict improvement and prolonged length of stay after CAD surgery. This research aimed to establish which preoperative clinical and demographic characteristics are present in Puerto Rico patients that require inpatient rehabilitation after cardiac surgery.
Record review evaluating clinical and sociodemographic variables of patients with cardiac surgery and it relationship with or without cardiac rehabilitation referral. A total of 65 records were selected: 17 records referred for inpatient rehabilitation and 48 records of patients who were discharged home.
Older patients > 65 y/o, living alone with no caregiver availability, impaired functional status, surgical status (urgent/ emergency surgery), concomitant valve surgery, BMI > 24.9, HgbA1C > 7.0%, female gender, CVA history, COPD history, PVD history, and prior weakness contribute to a functional decline, and are more likely to be associated with a referral to inpatient rehabilitation.
An identification of these variables before surgery could lead to early intervention by skill nursing facility departmental team. This early intervention can diminish later complications, postoperative and intensive care stay.
接受心脏手术的冠心病（CAD）或心脏瓣膜病患者是心脏康复的主要候选对象。心脏康复是一项多学科活动，旨在促进身体、心理和情绪恢复。多项研究评估了接受康复治疗的患者的术前特征，以预测冠心病手术后的改善情况和延长住院时间。本研究旨在确定波多黎各心脏手术后需要住院康复的患者术前存在哪些临床和人口统计学特征。
回顾记录，评估心脏手术患者的临床和社会人口统计学变量及其与是否接受心脏康复转诊的关系。共选取65份记录：17份转诊接受住院康复的记录和48份出院回家患者的记录。
年龄大于65岁、独居且无护理人员、功能状态受损、手术状态（急诊/紧急手术）、同期瓣膜手术、BMI>24.9、糖化血红蛋白>7.0%、女性、有脑血管意外病史、慢性阻塞性肺疾病病史、外周血管疾病病史以及既往身体虚弱会导致功能下降，且更有可能与转诊住院康复相关。
术前识别这些变量可促使技能护理设施部门团队进行早期干预。这种早期干预可减少后期并发症、术后和重症监护住院时间。
