Skip header and navigation

3 records – page 1 of 1.

Ambulatory surveillance of patients referred for cardiac rehabilitation following cardiac hospitalization: a feasibility study.

https://arctichealth.org/en/permalink/ahliterature125434
Source
Can J Cardiol. 2012 Jul-Aug;28(4):497-501
Publication Type
Article
Author
David A Alter
Juda Habot
Sherry L Grace
Terry Fair
David Kiernan
Wendy Clark
David Fell
Author Affiliation
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. david.alter@ices.on.ca
Source
Can J Cardiol. 2012 Jul-Aug;28(4):497-501
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - mortality - rehabilitation
Adult
Aged
Aged, 80 and over
Ambulatory Care
Angioplasty, Balloon, Coronary - mortality - rehabilitation
Coronary Artery Bypass - mortality - rehabilitation
Feasibility Studies
Female
Follow-Up Studies
Heart Valve Prosthesis Implantation - mortality - rehabilitation
Hospitalization
Hospitals, Community
Humans
Male
Middle Aged
Myocardial Infarction - mortality - rehabilitation
Ontario
Patient Readmission - statistics & numerical data
Population Surveillance - methods
Referral and Consultation
Survival Analysis
Waiting Lists
Abstract
Our purpose was to examine the feasibility of implementing an ambulatory surveillance system for monitoring patients referred to cardiac rehabilitation following cardiac hospitalizations.
This study consists of 1208 consecutive referrals to cardiac rehabilitation between October 2007 and April 2008. Patient attendance at cardiac rehabilitation, waiting times for cardiac rehabilitation, and adverse events while waiting for cardiac rehabilitation were tracked by telephone surveillance by a nurse.
Among the 1208 consecutive patients referred, only 44.7% attended cardiac rehabilitation; 36.4% of referred patients were known not to have attended any cardiac rehabilitation, while an additional 18.9% of referred patients were lost to follow-up. Among the 456 referred patients who attended the cardiac rehabilitation program, 19 (4.2%) experienced an adverse event while in the queue (13 of which were for cardiovascular hospitalizations with no deaths), with mean waiting times of 20 days and 24 days among those without and with adverse events, respectively. Among the 440 referred patients who were known not to have attended any cardiac rehabilitation program, 114 (25.9%) had adverse clinical events while in the queue; 46 of these events required cardiac hospitalization and 8 patients died.
Ambulatory surveillance for cardiac rehabilitation referrals is feasible. The high adverse event rates in the queue, particularly among patients who are referred but who do not attend cardiac rehabilitation programs, underscores the importance of ambulatory referral surveillance systems for cardiac rehabilitation following cardiac hospitalizations.
PubMed ID
22480901 View in PubMed
Less detail

Cardiac rehabilitation after coronary artery bypass surgery: 10-year results on mortality, morbidity and readmissions to hospital.

https://arctichealth.org/en/permalink/ahliterature194019
Source
J Cardiovasc Risk. 2001 Jun;8(3):153-8
Publication Type
Article
Date
Jun-2001
Author
B. Hedbäck
J. Perk
M. Hörnblad
U. Ohlsson
Author Affiliation
Department of Internal Medicine and Rehabilitation, Oskarshamn Hospital, Oskarshamn, Sweden. Bo.Hedback@lio.se
Source
J Cardiovasc Risk. 2001 Jun;8(3):153-8
Date
Jun-2001
Language
English
Publication Type
Article
Keywords
Adult
Aged
Angioplasty, Balloon, Coronary - mortality - rehabilitation
Blood Pressure - physiology
Cardiovascular Diseases - mortality - rehabilitation - therapy
Coronary Artery Bypass - mortality - rehabilitation
Female
Follow-Up Studies
Humans
Male
Middle Aged
Patient Readmission
Risk factors
Survival Analysis
Sweden - epidemiology
Time
Treatment Outcome
Abstract
To evaluate the long-term secondary preventive effect of a comprehensive rehabilitation programme after coronary artery bypass grafting (CABG).
The study group included 49 consecutive patients who underwent bypass surgery and were then offered a rehabilitation programme consisting of education in risk-factor control, a physical training programme and regular follow-up at a post-CABG clinic. The control group (n = 98), consisting of two well-matched CABG patients for each study patient, was offered the usual care with no access to a cardiac rehabilitation programme. The two groups were followed for 10 years and the results regarding cardiovascular mortality, morbidity, total cardiac events and readmissions to hospital were compared.
The total mortality (study group 8.2%, control group 20.4%) and cardiovascular mortality (8.2 versus 15.3%) after 10 years did not differ significantly between the groups. In the study group, nine patients (18.4%) had 10 cardiac events (four cardiovascular deaths, five non-fatal myocardial infarctions and one CABG) compared to 34 patients (34.7%, P
PubMed ID
11455847 View in PubMed
Less detail

Shared care for open heart surgery: 21 years' experience.

https://arctichealth.org/en/permalink/ahliterature213588
Source
Can J Cardiol. 1996 Jan;12(1):59-64
Publication Type
Article
Date
Jan-1996
Author
G M FitzGibbon
W J Keon
Author Affiliation
National Defence Medical Centre, Ottawa, Ontario.
Source
Can J Cardiol. 1996 Jan;12(1):59-64
Date
Jan-1996
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Coronary Artery Bypass - mortality - rehabilitation
Female
Follow-Up Studies
Health Services Research
Hospital Shared Services - organization & administration
Hospitals, Military
Hospitals, Special
Humans
Length of Stay
Male
Middle Aged
Ontario
Outcome Assessment (Health Care)
Patient Transfer - organization & administration
Postoperative Care
Referral and Consultation - organization & administration
Time Factors
Abstract
To determine whether patients undergoing open heart surgery, the majority coronary artery bypass grafting (CABG), can safely be returned early to the smaller nonspecialized hospital that referred them for postoperative care by a cardiological team. Another objective is to determine what benefits might accrue from this practice and to whose credit.
All 1696 patients, 1512 having coronary bypass alone or with ventricular aneurysm repair in 6%, referred from a military hospital with investigative facilities from November 1971 to November 1992 were studied with attention to length of postoperative stay in both hospitals, perioperative mortality and major complications mandating return to the surgical centre (which was almost always for reoperation). Time between initial coronary angiography and CABG was examined to see whether it related to the early return policy.
After the first two years, postoperative care at the surgical hospital following CABG was reduced from a mean of 10.4 to 2.4 days, with an 18% reduction in the combined time spent at both hospitals, an estimated reduction of some 48 patient-years at the surgical hospital. A perceived need for active in-patient-rehabilitation and formal postoperative assessment explains the somewhat higher than average 23-day combined hospital stay after CABG. There have been no cardiovascular problems associated with the process of patient transfer and the three postoperative deaths that occurred in the referring hospital do not appear related to early transfer. Most of the 29 patients (2%) returned to the surgical hospital during the postoperative phase to have reoperations; there were three deaths, inevitable in one, scarcely preventable in two and unrelated to the early transfer in all three. Overall perioperative mortality was 2.7%; it was 1.3% for isolated primary CABG, 7.7% for reoperation. Delay between angiography and CABG was less than one day in 9%, less than four weeks in 69% and less than 12 weeks in 96%. It is believed that rapid access to surgical treatment was facilitated by cardiologists' willingness to undertake postoperative care and by the amicable trusting relationship between staff of the two hospitals.
It is possible to transfer patients safely after open heart surgery to a smaller, nonspecialized hospital for postoperative care; there are no significant ill effects from the practice and obvious benefits accrue to several involved parties. This model of shared care may have lessons for those designing or modifying cardiac surgical care programs.
PubMed ID
8595570 View in PubMed
Less detail