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Comparison of cardiac rehabilitation outcomes in individuals with respiratory, cardiac or no comorbidities: A retrospective review

OBJECTIVE: To describe the prevalence and impact of respiratory comorbidities on patients undergoing cardiac rehabilitation (CR). METHODS: A retrospective review of a CR database (1999 to 2004) of patients with ischemic heart disease with ≥10 pack per year (ppy) smoking history and respiratory comor...

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Autores principales: Nonoyama, Mika L, Kin, Susan Marzolini R, Brooks, Dina, Oh, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Pulsus Group Inc 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4948575/
https://www.ncbi.nlm.nih.gov/pubmed/27471422
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author Nonoyama, Mika L
Kin, Susan Marzolini R
Brooks, Dina
Oh, Paul
author_facet Nonoyama, Mika L
Kin, Susan Marzolini R
Brooks, Dina
Oh, Paul
author_sort Nonoyama, Mika L
collection PubMed
description OBJECTIVE: To describe the prevalence and impact of respiratory comorbidities on patients undergoing cardiac rehabilitation (CR). METHODS: A retrospective review of a CR database (1999 to 2004) of patients with ischemic heart disease with ≥10 pack per year (ppy) smoking history and respiratory comorbidities (RC), non-respiratory comorbidities (NRC) and no comorbidities (NC) was performed. Primary outcomes at zero, six and 12 months included peak oxygen uptake (VO(2peak)), maximum workload, resting heart rate, ventilatory anaerobic threshold and anthropometrics. Analyses were performed on individuals who completed the program, adjusting for age, sex and baseline VO(2peak). RESULTS: Of 5922 patients, 1247 had ≥10 ppy smoking history: 77 (6.2%) had RC; 957 (76.7%) had NRC; and 213 (17.1%) had NC. The program completion rate for each group was similar for the RC (46.8%), NRC (55.8%) and NC groups (57.3%) (P=0.26). The RC group had the lowest baseline fitness levels (P<0.002). For VO(2peak), there were significant differences among groups (P=0.02) and improvements over program duration (P<0.0001). There were no significant differences in other outcomes. CONCLUSIONS: There was a low prevalence of patients with comorbid chronic obstructive pulmonary disease in CR when based on physician referral documentation. This is likely underestimated and/or reflects a referral bias. Diagnostic testing at CR entry would provide a more accurate measure of the prevalence and severity of disease. CR participation resulted in significant and similar improvements in most key CR outcomes in all groups including similar completion rate. A CR model was effective for patients with coexisting RCs. Strategies to improve access and diagnosis should be explored.
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spelling pubmed-49485752016-07-28 Comparison of cardiac rehabilitation outcomes in individuals with respiratory, cardiac or no comorbidities: A retrospective review Nonoyama, Mika L Kin, Susan Marzolini R Brooks, Dina Oh, Paul Can J Respir Ther Original Article OBJECTIVE: To describe the prevalence and impact of respiratory comorbidities on patients undergoing cardiac rehabilitation (CR). METHODS: A retrospective review of a CR database (1999 to 2004) of patients with ischemic heart disease with ≥10 pack per year (ppy) smoking history and respiratory comorbidities (RC), non-respiratory comorbidities (NRC) and no comorbidities (NC) was performed. Primary outcomes at zero, six and 12 months included peak oxygen uptake (VO(2peak)), maximum workload, resting heart rate, ventilatory anaerobic threshold and anthropometrics. Analyses were performed on individuals who completed the program, adjusting for age, sex and baseline VO(2peak). RESULTS: Of 5922 patients, 1247 had ≥10 ppy smoking history: 77 (6.2%) had RC; 957 (76.7%) had NRC; and 213 (17.1%) had NC. The program completion rate for each group was similar for the RC (46.8%), NRC (55.8%) and NC groups (57.3%) (P=0.26). The RC group had the lowest baseline fitness levels (P<0.002). For VO(2peak), there were significant differences among groups (P=0.02) and improvements over program duration (P<0.0001). There were no significant differences in other outcomes. CONCLUSIONS: There was a low prevalence of patients with comorbid chronic obstructive pulmonary disease in CR when based on physician referral documentation. This is likely underestimated and/or reflects a referral bias. Diagnostic testing at CR entry would provide a more accurate measure of the prevalence and severity of disease. CR participation resulted in significant and similar improvements in most key CR outcomes in all groups including similar completion rate. A CR model was effective for patients with coexisting RCs. Strategies to improve access and diagnosis should be explored. Pulsus Group Inc 2016 /pmc/articles/PMC4948575/ /pubmed/27471422 Text en © 2016 Canadian Society of Respiratory Therapists. All rights reserved This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (http://creativecommons.org/licenses/by-nc/4.0/), which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes. For commercial reuse, contact reprints@pulsus.com
spellingShingle Original Article
Nonoyama, Mika L
Kin, Susan Marzolini R
Brooks, Dina
Oh, Paul
Comparison of cardiac rehabilitation outcomes in individuals with respiratory, cardiac or no comorbidities: A retrospective review
title Comparison of cardiac rehabilitation outcomes in individuals with respiratory, cardiac or no comorbidities: A retrospective review
title_full Comparison of cardiac rehabilitation outcomes in individuals with respiratory, cardiac or no comorbidities: A retrospective review
title_fullStr Comparison of cardiac rehabilitation outcomes in individuals with respiratory, cardiac or no comorbidities: A retrospective review
title_full_unstemmed Comparison of cardiac rehabilitation outcomes in individuals with respiratory, cardiac or no comorbidities: A retrospective review
title_short Comparison of cardiac rehabilitation outcomes in individuals with respiratory, cardiac or no comorbidities: A retrospective review
title_sort comparison of cardiac rehabilitation outcomes in individuals with respiratory, cardiac or no comorbidities: a retrospective review
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4948575/
https://www.ncbi.nlm.nih.gov/pubmed/27471422
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