Early rehabilitation after acute myocardial infarction: A nationwide inpatient database study.
Activity of daily living
Early rehabilitation
Intensive care unit
Myocardial infarction
Percutaneous coronary intervention
Journal
Journal of cardiology
ISSN: 1876-4738
Titre abrégé: J Cardiol
Pays: Netherlands
ID NLM: 8804703
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
received:
10
03
2021
revised:
11
05
2021
accepted:
06
06
2021
pubmed:
8
7
2021
medline:
1
12
2021
entrez:
7
7
2021
Statut:
ppublish
Résumé
The effects and safety of early rehabilitation in intensive care units (ICU) remain unclear for patients after acute myocardial infarction (AMI). Using Japanese Diagnosis Procedure Combination inpatient data between July 2010 and March 2018, we identified 31,603 adult patients with AMI who underwent percutaneous coronary intervention on the day of admission and who were admitted to the ICU for more than three consecutive days. Patients who started a rehabilitation program within three days of ICU admission were included in the early rehabilitation group, while others were included in the usual care group. The primary outcome was activities of daily living (ADL) at discharge, as measured using the Barthel Index score. We conducted inverse probability of treatment weighting analyses. The data of 31,603 patients were examined, 5,147 of whom were assigned to the early rehabilitation group. In the weighted cohort, the Barthel Index score at discharge was not significantly different between the two groups. The early rehabilitation group had a significantly shorter hospital stay, shorter ICU stay, and lower total hospitalization costs. No correlations were observed between early rehabilitation and ADL at discharge. However, the present results suggest that early rehabilitation is safe and associated with lower hospital costs and shorter hospital stays after AMI.
Sections du résumé
BACKGROUND
The effects and safety of early rehabilitation in intensive care units (ICU) remain unclear for patients after acute myocardial infarction (AMI).
METHODS
Using Japanese Diagnosis Procedure Combination inpatient data between July 2010 and March 2018, we identified 31,603 adult patients with AMI who underwent percutaneous coronary intervention on the day of admission and who were admitted to the ICU for more than three consecutive days. Patients who started a rehabilitation program within three days of ICU admission were included in the early rehabilitation group, while others were included in the usual care group. The primary outcome was activities of daily living (ADL) at discharge, as measured using the Barthel Index score. We conducted inverse probability of treatment weighting analyses.
RESULTS
The data of 31,603 patients were examined, 5,147 of whom were assigned to the early rehabilitation group. In the weighted cohort, the Barthel Index score at discharge was not significantly different between the two groups. The early rehabilitation group had a significantly shorter hospital stay, shorter ICU stay, and lower total hospitalization costs.
CONCLUSIONS
No correlations were observed between early rehabilitation and ADL at discharge. However, the present results suggest that early rehabilitation is safe and associated with lower hospital costs and shorter hospital stays after AMI.
Identifiants
pubmed: 34229920
pii: S0914-5087(21)00154-4
doi: 10.1016/j.jjcc.2021.06.004
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
456-462Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2021 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no conflict of interest.