Salzwedel Annett, Nosper Manfred, Röhrig Bernd, Linck-Eleftheriadis Sigrid, Strandt Gert, Völler Heinz
Department of Clinical Pharmacology and Toxicology, Charité (CBF) Berlin, Germany.
Eur J Prev Cardiol. 2014 Feb;21(2):172-80. doi: 10.1177/2047487312469475. Epub 2012 Nov 20.
Outcome quality management requires the consecutive registration of defined variables. The aim was to identify relevant parameters in order to objectively assess the in-patient rehabilitation outcome.
From February 2009 to June 2010 1253 patients (70.9 ± 7.0 years, 78.1% men) at 12 rehabilitation clinics were enrolled. Items concerning sociodemographic data, the impairment group (surgery, conservative/interventional treatment), cardiovascular risk factors, structural and functional parameters and subjective health were tested in respect of their measurability, sensitivity to change and their propensity to be influenced by rehabilitation.
The majority of patients (61.1%) were referred for rehabilitation after cardiac surgery, 38.9% after conservative or interventional treatment for an acute coronary syndrome. Functionally relevant comorbidities were seen in 49.2% (diabetes mellitus, stroke, peripheral artery disease, chronic obstructive lung disease). In three key areas 13 parameters were identified as being sensitive to change and subject to modification by rehabilitation: cardiovascular risk factors (blood pressure, low-density lipoprotein cholesterol, triglycerides), exercise capacity (resting heart rate, maximal exercise capacity, maximal walking distance, heart failure, angina pectoris) and subjective health (IRES-24 (indicators of rehabilitation status): pain, somatic health, psychological well-being and depression as well as anxiety on the Hospital Anxiety and Depression Scale).
The outcome of in-patient rehabilitation in elderly patients can be comprehensively assessed by the identification of appropriate key areas, that is, cardiovascular risk factors, exercise capacity and subjective health. This may well serve as a benchmark for internal and external quality management.
结果质量管理需要对定义的变量进行连续记录。目的是确定相关参数，以便客观评估住院康复结果。
2009年2月至2010年6月，12家康复诊所的1253名患者（70.9±7.0岁，78.1%为男性）入组。对有关社会人口统计学数据、损伤组（手术、保守/介入治疗）、心血管危险因素、结构和功能参数以及主观健康的项目进行了可测量性、对变化的敏感性以及受康复影响倾向的测试。
大多数患者（61.1%）在心脏手术后接受康复治疗，38.9%在急性冠状动脉综合征接受保守或介入治疗后接受康复治疗。49.2%的患者存在功能相关的合并症（糖尿病、中风、外周动脉疾病、慢性阻塞性肺疾病）。在三个关键领域，确定了13个对变化敏感且可通过康复改变的参数：心血管危险因素（血压、低密度脂蛋白胆固醇、甘油三酯）、运动能力（静息心率、最大运动能力、最大步行距离、心力衰竭、心绞痛）和主观健康（IRES-24（康复状态指标）：疼痛、躯体健康、心理健康和抑郁以及医院焦虑抑郁量表上的焦虑）。
通过确定适当的关键领域，即心血管危险因素、运动能力和主观健康，可以全面评估老年患者的住院康复结果。这很可能作为内部和外部质量管理的基准。
