Article

This study examined whether involvement in a pre-surgical cardiac
rehabilitation programme conferred a long-term survival benefit. DESIGN: Patients
randomly allocated to a pre-surgical cardiac rehabilitation programme
intervention or a control group were tracked through national databases at a
point approximately 12 years later, and all causes of mortality were identified
from death records. Kaplan-Meier survival analyses based on involvement in a
cardiac rehabilitation programme and known pre-surgical risk factors were carried
out. SETTING: Two health boards in the west of Scotland, referring to a single
cardiothoracic tertiary centre. SUBJECTS: Patients admitted to the waiting list
for coronary artery bypass surgery. INTERVENTIONS: Patients were randomly
allocated to a control group ('usual' care) or an intervention group (nurse-led
cardiac rehabilitation) in the pre-operative phase. They were followed up at 12
years post surgery. MAIN MEASURES: The only outcome measure used for analysis was
survival. Measures of anxiety and depression, and physiological and lifestyle
risk factors were included as independent variables in analysis of death.
RESULTS: The initial study included 110 patients--none were lost to follow-up.
Relative risk of death associated with inclusion in the cardiac rehabilitation
programme was 0.814; risk of death increased with increasing pre-surgical
depression (RR 1.07) and anxiety (RR 1.09). CONCLUSIONS: Undertaking pre-surgical
cardiac rehabilitation confers a long-term survival advantage over patients not
offered this service. Increased anxiety and depression in the pre-surgical phase
are additional risk factors for increased mortality.

Langue : ANGLAIS