Share This Article:

Age-Dependency of Clinical Characteristics of Patients Participating Cardiovascular Rehabilitation Results from the German

Abstract Full-Text HTML XML Download Download as PDF (Size:2559KB) PP. 207-216
DOI: 10.4236/ojtr.2014.24026    2,450 Downloads   2,885 Views   Citations

ABSTRACT

Background: Cardiovascular rehabilitation in Germany traditionally is offered as inpatient service often located far from patient’s residence, and ambulatory rehabilitation still represents a minority. The German Registry of Ambulatory Cardiac Rehabilitation (KARREE) was designed to contribute to rehabilitation quality assurance and to evaluate clinical characteristics of patients participating in ambulatory rehabilitation centers. Methods: In four ambulatory rehabilitation centers 2989 patients were consecutively registered from 2008 to 2011 and evaluated with respect to social status, cardiovascular diagnoses and risk factors, psychological status, medication and short term clinical and social outcome. Results: Most patients referred to the ambulatory cardiac rehabilitation had an acute cardiovascular event, with patients after acute coronary syndrome representing the majority (59.9%). Female were strongly underrepresented (16.7%). Patient’s clinical characteristics varied with the age groups evaluated (<50 years, 50 - 70 years, > 70 years). Whereas the reported physical inactivity, overweight and cigarette smoking was declining with age, diabetes and hypertension significantly increased. Furthermore the reported and evaluated psychosocial stress was declining with age. Regarding the group of patients still employed, 43.5 % were estimated as fit for work directly at the end of the rehabilitation program, whereas a stepwise reintegration into employment was performed in 16.7%. The majority of patients were transferred to ambulatory heart groups or other forms of after care for stabilizing regular physical activity. Conclusions: The large variation of the characteristics of patients participating cardiac rehabilitation underscore the need of an individualized approach for a successful implementation of secondary prevention and reintegration of these patients into their social life.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Nebel, R. , Marx, M. , Geier, M. , Buran-Kilian, B. , Ouarrak, T. , Guha, M. , Sauer, G. , Bönner, G. , Hahmann, H. , Jordan, R. , Engelhard, M. , Rauch, B. and Bjarnason-Wehrens, B. (2014) Age-Dependency of Clinical Characteristics of Patients Participating Cardiovascular Rehabilitation Results from the German. Open Journal of Therapy and Rehabilitation, 2, 207-216. doi: 10.4236/ojtr.2014.24026.

References

[1] Korsukéwitz, Ch., Rohwetter, M. and Rauch, B. (2007) Definition und rechtliche Grundlagen der Rehabilitation. In: Kardiologische Rehabilitation, Standards für die Praxis nach den Leitlinien der Deutschen Gesellschaft für Prävention und Rehabilitation von Herz-Kreislauferkrankungen e.V. (DGPR), Referenz-Reihe, Georg Thieme Verlag, 4-6, ISBN 978-3-13-143141-7.
[2] Korsukéwitz, C., Falk, J. and Lindow, B. (2012) Kardiologische Rehabilitation in Deutschland. Erfolgsmodell mit Perspektive: Herz, 37, 12-21.
[3] Willich, S.N., Müller-Nordhorn, J., Kulig, M., Binting, S., Gohlke, H., Hahmann, H., Bestehorn, K., Krobot, K. and Völler, H., PIN-Study Group. (2001) Cardiac Risk Factors, Medication, and Recurrent Clinical Events after Acute Coronary Disease. A Prospective Cohort Study. European Heart Journal, 22, 307-313. http://dx.doi.org/10.1053/euhj.2000.2294
[4] Bestehorn, K., Wegscheider, K. and Völler, H. (2008) Contemporary Trends in Cardiac Rehabilitation in Germany: Patient Characteristics, Drug Treatment, and Risk-Factor Management from 2000 to 2005. European Journal of Preventive Cardiology, 15, 312-318.
http://dx.doi.org/10.1097/HJR.0b013e3282f40e14
[5] Jünger, C., Rauch, B., Schneider, S., Liebhart, N., Rauch, G., Senges, J. and Bestehorn, K. (2010) Effect of Early Short-Term Cardiac Rehabilitation after Acute ST-Elevation and Non-ST-Elevation Myocardial Infarction on 1-Year Mortality. Current Medical Research and Opinion, 26, 803-811.
http://dx.doi.org/10.1185/03007991003604216
[6] Schwaab, B., Waldmann, A., Katalinic, A., Sheikhzadeh, A. and Raspe, H. (2011) In-Patient Cardiac Rehabilitation Versus Medical Care—A Prospective Multicentre Controlled 12 Months Follow-Up in Patients with Coronary Heart Disease. European Journal of Preventive Cardiology, 18, 581-586.
http://dx.doi.org/10.1177/1741826710389392
[7] Rauch, B., Riemer, T., Schwaab, B., Schneider, S., Diller, F., Gohlke, H., Schiele, R., Katus, H., Gitt, A. and Senges, J., for the OMEGA Study Group. (2014) Short-Term Comprehensive Cardiac Rehabilitation after AMI Is Associated with Reduced 1-Year Mortality: Results from the OMEGA Study. European Journal of Preventive Cardiology, 21, 1060-1069.
http://dx.doi.org/10.1177/2047487313486040
[8] Mayer-Berger, W., Simic, D., Mahmoodzad, J., Burtscher, R., Kohlmeyer, M., Schwitalla, B. and Redaèlli, M. (2014) Efficacy of a Long-Term Secondary Prevention Programme Following Inpatient Cardiovascular Rehabilitation on Risk and Health-Related Quality of Life in a Low-Education Cohort: A Randomized Controlled Study. European Journal of Preventive Cardiology, 21, 145-152. http://dx.doi.org/10.1177/2047487312465526
[9] Salzwedel, A., Nosper, M., Röhrig, B., Linck-Eleftheriadis, S., Strandt, G. and Völler, H. (2014) Outcome Quality of In-Patient Cardiac Rehabilitation in Elderly Patients—Identification of Relevant Parameters. European Journal of Preventive Cardiology, 21, 172-180. http://dx.doi.org/10.1177/2047487312469475
[10] Bjarnason-Wehrens, B., Predel, H.G., Graf, C. and Rost, R. (1999) Ambulante kardiale Rehabilitation der Phase II— Kölner Modell“—einschließlich der Ergebnisse drei Jahre nach Abschluss der Rehabilitation. Herz, 24, 9-23. http://dx.doi.org/10.1007/BF03042127
[11] Gysan, D., Heinzler, R. and Schmidt, K. (1999) Auswirkungen einer vierwöchigen ambulanten kardialen Rehabilitationsmaßnahme (Phase II) auf kardiovaskuläre Risikofaktoren, körperliche Belastbarkeit und berufliche Reintegration bei Patienten nach Myokardinfarkt, Dilatationsbehandlung und Herzoperation. Herz, 24, 44-56. http://dx.doi.org/10.1007/BF03042131
[12] Wendt, T. (1999) Ambulante Phase II Rehabilitation Herzkranker an einem im Ballungsraum Rhein-Main gelegenen Akutkrankenhaus: Das Frankfurter Modell. Herz, 24, 57-62.
http://dx.doi.org/10.1007/BF03042132
[13] Bjarnason-Wehrens, B., Bott, D., Benesch, L., Bischoff, K.O., Buran-Kilian, B., Gysan, D., Hollenstein, U., Mayer-Berger, W., Wilkniss, R. and Sauer, G. (2007) Long-Term Results of a Three-Week Intensive Cardiac Out-Patient Rehabilitation Program in Motivated Patients with Low Social Status. Clinical Research in Cardiology, 96, 77-85. http://dx.doi.org/10.1007/s00392-007-0461-0
[14] Bundesarbeitsgemeinschaft für Rehabilitation, BAR (2005) Rahmenempfehlungen zur ambulanten kardiologischen Rehabilitation. Frankfurt am Main, Dezember 2005.
[15] Badura, B., Grande, G., Janßen, H. and Schott, T. (1994) Evaluation kardiologischer Rehabilitationein Vergleich von Struktur-, Prozess- und Ergebnisqualität stationärer und ambulanter Anschlussheilbehandlung. In: Die Betriebskrankenkasse; Zeitschr. des Bundesverbandes der Betriebskrankenkassen, Essen, 500-517.
[16] Iseringhausen, O., Schott, T. and vom Order, A. (2002) Die Qualität der Organisation Kardiologischer Rehabilitation—Ein Vergleich stationärer und ambulanter Versorgungsformen. Rehabilitation, 41, 130-139. http://dx.doi.org/10.1055/s-2002-28447
[17] Schweikert, B., Hahmann, H., Steinacker, J.M., et al. (2009) Intervention Study Shows Outpatient Cardiac Rehabilitation to Be Economically at Least as Attractive as Inpatient Rehabilitation. Clinical Research in Cardiology, 98, 787-795. http://dx.doi.org/10.1007/s00392-009-0081-6
[18] Steinacker, J.M., Li, Y., Muche, R., Koenig, W., Hahmann, H., Imhof, A., Kropf, C., Brandstetter, S., Schweikert, B., Leidl, R. and Schiefer, D.H. (2011) Long Term Effects of Comprehensive Cardiac Rehabilitation in an Inpatient and Outpatient Setting. Swiss Medical Weekly, 140, Article ID: w13141.
[19] Völler, H. (2013) Rehabilitation. In: Deutscher Herzbericht 2013, Deutsche Herzstiftung (Hrsg.), Deutsche Herzstiftung e.V., Frankfurt am Main, 180-185, ISBN 978-3-9811926-6-7.
[20] Karoff, M., Müller-Fahrnow, W., Kittel, J., Vetter, H.O., Gülker, H. and Spyra, C. (2002) Outpatient Cardiological Rehabilitation—Acceptance and Conditions Related to Choice of Setting. Die Rehabilitation, 41, 167-174. http://dx.doi.org/10.1055/s-2002-28441
[21] Buchwalsky, G., Buchwalsky, R. and Held, K. (2002) Langzeitwirkungen der Nachsorge in einer ambulanten Herzgruppe. Eine Fall-Kontrollstudie. Zeitschrift für Kardiologie, 91, 139-146.
http://dx.doi.org/10.1007/s003920200003
[22] Giannuzzi, P., Temporelli, L., Marchioli, R., Maggioni, A., Balestroni, G., Ceci, V., Chieffo, C., Gattone, M., Griffo, R., Schweiger, C., Tavazzi, L., Urbinati, S., Valagussa, F. and Vanuzzo, D., GOSPEL Investigators (2008) Globalsecondary Prevention Strategies to Limit Event Recurrence after Myocardial Infarction. JAMA Internal Medicine, 168, 2194-2204.
http://dx.doi.org/10.1001/archinte.168.20.2194

  
comments powered by Disqus

Copyright © 2018 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.