Olsen Siv Js, Schirmer Henrik, Bønaa Kaare H, Hanssen Tove A
1 Division of Internal Medicine, University Hospital of North Norway, Norway.
2 Cardiovascular Research Group, The Arctic University of Norway, Norway.
Eur J Cardiovasc Nurs. 2018 Mar;17(3):273-279. doi: 10.1177/1474515117737766. Epub 2017 Oct 19.
The purpose of this study was to estimate the proportion of Norwegian coronary heart disease patients participating in cardiac rehabilitation programmes after percutaneous coronary intervention, and to determine predictors of cardiac rehabilitation participation.
Participants were patients enrolled in the Norwegian Coronary Stent Trial. We assessed cardiac rehabilitation participation in 9013 of these patients who had undergone their first percutaneous coronary intervention during 2008-2011. Of these, 7068 patients (82%) completed a self-administered questionnaire on cardiac rehabilitation participation within three years after their percutaneous coronary intervention.
Twenty-eight per cent of the participants reported engaging in cardiac rehabilitation. Participation rate differed among the four regional health authorities in Norway, varying from 20%-31%. Patients undergoing percutaneous coronary intervention for an acute coronary syndrome were more likely to participate in cardiac rehabilitation than patients with stable angina (odds ratio 3.2; 95% confidence interval 2.74-3.76). A multivariate statistical model revealed that men had a 28% lower probability ( p<0.001) of participating in cardiac rehabilitation, and the odds of attending cardiac rehabilitation decreased with increasing age ( p<0.001). Contributors to higher odds of cardiac rehabilitation participation were educational level >12 years (odds ratio 1.50; 95% confidence interval 1.32-1.71) and body mass index>25 (odds ratio 1.19; 95% confidence interval 1.05-1.36). Prior coronary artery bypass graft was associated with lower odds of cardiac rehabilitation participation (odds ratio 0.47; 95% confidence interval 0.32-0.70) Conclusion: The estimated cardiac rehabilitation participation rate among patients undergoing first-time percutaneous coronary intervention is low in Norway. The typical participant is young, overweight, well-educated, and had an acute coronary event. These results varied by geographical region.
本研究旨在评估挪威经皮冠状动脉介入治疗后参与心脏康复计划的冠心病患者比例，并确定心脏康复参与情况的预测因素。
研究对象为纳入挪威冠状动脉支架试验的患者。我们评估了在2008年至2011年期间接受首次经皮冠状动脉介入治疗的9013例患者的心脏康复参与情况。其中，7068例患者（82%）在经皮冠状动脉介入治疗后的三年内完成了一份关于心脏康复参与情况的自填问卷。
28%的参与者报告参与了心脏康复。挪威四个地区卫生当局的参与率有所不同，从20%至31%不等。因急性冠状动脉综合征接受经皮冠状动脉介入治疗的患者比稳定型心绞痛患者更有可能参与心脏康复（比值比3.2；95%置信区间2.74 - 3.76）。多变量统计模型显示，男性参与心脏康复的概率低28%（p<0.001），且参与心脏康复的几率随年龄增长而降低（p<0.001）。参与心脏康复几率较高的因素包括教育水平>12年（比值比1.50；95%置信区间1.32 - 1.71）和体重指数>25（比值比1.19；95%置信区间1.05 - 1.36）。既往冠状动脉搭桥术与参与心脏康复的几率较低相关（比值比0.47；95%置信区间0.32 - 0.70）。结论：挪威首次接受经皮冠状动脉介入治疗的患者中，估计的心脏康复参与率较低。典型的参与者为年轻、超重、受过良好教育且发生过急性冠状动脉事件的患者。这些结果因地理区域而异。
