Long-term effects of outpatient cardiac rehabilitation in Austria: a nationwide registry

Nachhaltige Wirkung der ambulanten kardiologischen Rehabilitation in Österreich: Daten aus einem Österreichweiten Register

Summary

Aim

Our Working Group on Out-Patient Cardiac Rehabilitation (AGAKAR) has previously published guidelines, which were endorsed by the Austrian Society of Cardiology. It was the aim of this study to assess the short-term (phase II) and long-term (phase III) effects of these guidelines by use of a nationwide registry.

Methods

All Austrian out-patient rehabilitation facilities entered data into a database of all consecutive patients who completed phase II (4–6 weeks) and/or III (6–12 months) rehabilitation between 1.1.2009–30.11.2011.

Results

Data of 1432 phase II and 1390 phase III patients were assessed. Despite the wide spectrum of cardiac diseases patients’ exercise capacity improved during phase II by 20 (− 193 to 240) watts; 91.0 % reached a systolic blood pressure < 140 mmHg; 68.1 % an LDL < 100 mg/dl; 69.8 % triglycerides < 150 mg/dl, and 66.2 % of male patients had a waist circumference < 102 cm. During phase III improvement in cardiovascular risk factors, quality of life, anxiety, and depression were further improved in an increasing number of patients.

Conclusions

Our data demonstrate beneficial short- and long-term effects of the Austrian model of out-patient cardiac rehabilitation and provide support for comprehensive long-term rehabilitation programs. Furthermore, our model might be helpful for those who are at the verge of initiating or modifying their programs. It is also hoped that these data will motivate colleagues to refer their patients to out-patient cardiac rehabilitation facilities and that our results may stimulate insurance companies to grant further and comprehensive contracts to provide access for all suitable patients.

Zusammenfassung

Ziel

Es war Ziel dieser Studie, die Wirksamkeit der ambulanten kardiologischen Rehabilitation Phase II und III nach dem Modell der Arbeitsgemeinschaft für ambulante kardiologische Rehabilitation (AGAKAR), folgend den Guidelines der Österreichischen Kardiologischen Gesellschaft (ÖKG), zu untersuchen.

Methodik

Alle Ambulatorien, die Vertragspartner der Österreichischen Sozialversicherungen sind, gaben die Daten aller Patienten, die zwischen 1.1.2009–30.11.2011 eine ambulante kardiologische Rehabilitation der Phase II und III abschlossen, prospektiv in eine Web-basierte Datenbank ein.

Ergebnisse

Es gelangten für die Phase II 1432 und für die Phase III 1390 Datensätze zur Auswertung. Während der Phase II verbesserten sich die Patienten um 20 (-193-240) Watt, erreichten 91,0 % einen systolischen Blutdruck von < 140 mmHg, 66,1 % ein LDL < 100 mg/dl, 69,8 % Triglyceride < 150 mg/dl und bei den Männern 66,2 % einen Bauchumfang < 102 cm. Am Ende der Phase III wurden die Zielwerte von einem noch größeren Teil der Patienten erreicht, wobei die Ergebnisse dann am besten waren, wenn der Phase III eine ambulante anstelle einer stationären Phase II vorausging. Auch nahmen Depression im Laufe der Phase II und III ab und verbesserte sich die Lebensqualität.

Schlussfolgerungen

Diese Daten beweisen die Wirksamkeit und Nachhaltigkeit der ambulanten kardiologischen Rehabilitation der Phase II und III nach dem Modell der AGAKAR und folgend den Guidelines der ÖKG, wobei die Phase III nicht nur nach einer ambulanten, sondern auch nach einer stationären Phase II nachhaltige Wirkung zeigte. Diese Ergebnisse sollten dazu Anlass geben, diese Evidenz-basierte und Leitlinien-konforme ambulante Rehabilitation lückenlos, flächendeckend, berufsbegleitend und wohnortnah anzubieten und nicht mehr nur auf wenige Zentren zu beschränken.

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Acknowledgments

The following colleagues and their teams contributed patients to this study:

Josef Niebauer, (University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Austria), Karl Mayr (Cardiomed—ambulante kardiologische Rehabilitation, Linz, Austria), Hanns Harpf (Krankenanstalt Institut für Bewegungstherapie Graz, Austria), Axel Philippi (Reha—Sport—Institut Feldkirch, Austria), Edith Huber (Ambulatorium Nord, Salzburg, Austria), Andrea Podolsky (Landesklinikum Krems, Institut für Präventiv- u. angewandte Sportmedizin, Krems, Austria), Gerald Zenker (Physikalisches Ambulatorium der Stadtwerke Bruck a.d. Mur, Austria), and Bernd Eber (Institut für Präventiv- und Rehabilitationsmedizin Cardio-Vital-WELS, Wels, Austria).

Conflict of interest

None declared.

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Correspondence to Prof. Josef Niebauer MD, PhD, MBA.

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Niebauer, J., Mayr, K., Harpf, H. et al. Long-term effects of outpatient cardiac rehabilitation in Austria: a nationwide registry. Wien Klin Wochenschr 126, 148–155 (2014). https://doi.org/10.1007/s00508-014-0527-3

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Keywords

  • Cardiovascular risk factors
  • Coronary artery disease
  • Exercise training
  • Lipids
  • Myocardial infarction

Schlüsselwörter

  • Kardiovaskuläre Risikofaktoren
  • Koronare Herzkrankheit
  • Körperliches Training
  • Lipide
  • Myokardinfarkt