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Early cardiac rehabilitation: could it improve functional outcomes and reduce length of stay and sanitary costs in patients aged 75 years or older? A retrospective case–control study

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Abstract

Background

Cardiac rehabilitation (CR) is considered as a cornerstone in improving physical function in older people after cardiac procedures; however, its effects in patients aged more than 75 years are still debated.

Aims

To assess the effectiveness of early CR in improving functional outcomes and reducing the length of stay (LOS) and sanitary costs in patients aged ≥ 75 years.

Methods

We retrospectively analysed data from medical records of patients aged ≥ 75 years performed CR after cardiac procedures. Patients were divided into two groups according to the median timing lasting from the cardiac procedure and CR start: ‘early rehabilitation’ (< 8 days) and ‘delayed rehabilitation’ (≥ 8 days). Six-minutes walking test (6MWT), left ventricular ejection fraction (LVEF), LOS, and sanitary costs were assessed.

Results

The 160 patients (mean aged 79.18 ± 3.13 years) included were divided into two groups: ‘early rehabilitation’ (n = 80) and ‘delayed rehabilitation’ (n = 80). Both groups showed a significant improvement (p < 0.0001) in 6MWT and LVEF but there were no differences between groups in all clinical outcomes. On the other hand, the ‘early rehabilitation’ group showed significantly lower LOS (25.8 ± 5.3 vs 34.1 ± 10.8 days; p < 0.0001) and sanitary costs (22,282.08 ± 3242.68 euros vs. 44,954.03 ± 22,160.11 euros; p < 0.0001).

Discussion

Beginning CR in the first week seems to be effective in improving physical performance after cardiac procedures in patients aged ≥ 75 years, reducing LOS and sanitary costs.

Conclusions

Our findings suggest that early CR could be performed with positive effects on functional outcomes, leading to a reduction in LOS and sanitary costs in elderly.

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Acknowledgements

The authors wish to thank Ennio Mantellini, MD and Miss Tatiana Bolgeo for their support in this work.

Funding

The study was not funded.

Author information

Authors and Affiliations

  1. Rehabilitation Unit, Rehabilitation Department, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy

    Marco Pizzorno, Manuela Desilvestri, Manuela Marchioni & Luca Perrero

  2. Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Viale Piazza D’Armi 1, 28100, Novara, Italy

    Lorenzo Lippi, Alessandro de Sire & Marco Invernizzi

  3. Department of Cardiothoracic and Vascular Surgery, Cardiac Surgery, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy

    Andrea Audo

  4. Rehabilitation Unit, ‘Mons. L. Novarese’ Hospital, Moncrivello, Vercelli, Italy

    Alessandro de Sire

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  1. Marco Pizzorno
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  2. Manuela Desilvestri
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  3. Lorenzo Lippi
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  6. Alessandro de Sire
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Contributions

All the authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by MP, LL, and AdS. The first draft of the manuscript was written by MP, LL, and AdS; all the other authors revised the manuscript. All the authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Alessandro de Sire.

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All the authors declare that they have no conflicts of interest.

Ethics approval

The study was approved by the Local Ethic Committee and the experiments comply with the current laws of the country in which they were performed.

Statement of human and animal rights

The procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national).

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Informed consent was obtained from all individual participants included in the study.

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Pizzorno, M., Desilvestri, M., Lippi, L. et al. Early cardiac rehabilitation: could it improve functional outcomes and reduce length of stay and sanitary costs in patients aged 75 years or older? A retrospective case–control study. Aging Clin Exp Res 33, 957–964 (2021). https://doi.org/10.1007/s40520-020-01589-x

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