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急性心力衰竭住院患者心脏康复的急性期启动对日常生活活动能力的短期改善作用

Acute-Phase Initiation of Cardiac Rehabilitation for Short-Term Improvement in Activities of Daily Living in Patients Hospitalized for Acute Heart Failure.

作者信息

Ueno Kensuke, Kamiya Kentaro, Kaneko Hidehiro, Okada Akira, Itoh Hidetaka, Fujiu Katsuhito, Takeda Norifumi, Morita Hiroyuki, Michihata Nobuaki, Jo Taisuke, Yasunaga Hideo, Komuro Issei

机构信息

Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan.

Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara 252-0373, Japan.

出版信息

J Cardiovasc Dev Dis. 2022 Mar 25;9(4):97. doi: 10.3390/jcdd9040097.

Abstract

BACKGROUND

Whether acute-phase cardiac rehabilitation (CR) is beneficial for short-term improvement in activities of daily living (ADL) in patients hospitalized for acute heart failure (AHF) remains unclear.

AIM

To investigate the association of acute-phase initiation of CR with short-term improvement in ADL in patients hospitalized for AHF.

METHODS

We retrospectively analyze data from the Diagnosis Procedure Combination Database, a nationwide inpatient database. Patients hospitalized for HF between January 2010 and March 2018 are included. Propensity score matching and generalized linear models are built to examine the association between improvement in ADL and acute-phase CR initiation, defined as the initiation of CR within two days of admission.

RESULTS

Among 306,826 eligible patients, CR is initiated in 45,428 patients (14.8%) within two days of hospital admission. Propensity score matching creates 45,427 pairs. CR initiation within two days of hospital admission is associated with ADL improvement (risk ratio: 1.018; 95% confidence interval: 1.004-1.032), particularly in elderly patients, females, and individuals with low ADL at admission, body mass index of 18.5-24.9 kg/m, and New York Heart Association class IV.

CONCLUSIONS

Our analyses highlight the possibility that acute-phase CR initiation may result in short-term improvement in ADL in patients hospitalized for AHF.

摘要

背景

急性心力衰竭(AHF)住院患者急性期心脏康复(CR)是否有利于短期改善日常生活活动能力(ADL)尚不清楚。

目的

探讨AHF住院患者急性期开始CR与ADL短期改善之间的关联。

方法

我们回顾性分析了来自全国住院患者数据库——诊断程序组合数据库的数据。纳入2010年1月至2018年3月期间因心力衰竭住院的患者。建立倾向评分匹配和广义线性模型,以检验ADL改善与急性期CR启动之间的关联,急性期CR启动定义为入院后两天内开始CR。

结果

在306,826名符合条件的患者中,45,428名患者(14.8%)在入院后两天内开始CR。倾向评分匹配产生了45,427对。入院后两天内开始CR与ADL改善相关(风险比:1.018;95%置信区间:1.004 - 1.032),特别是在老年患者、女性以及入院时ADL较低、体重指数为18.5 - 24.9 kg/m²和纽约心脏协会IV级的个体中。

结论

我们的分析突出了一种可能性,即急性期开始CR可能会使AHF住院患者的ADL得到短期改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d121/9025467/335376c1da4b/jcdd-09-00097-g001.jpg

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