Article

Risques et effets secondaires de la rééducation cardiaque
PURPOSE: To prospectively assess whether the Risk of Activity Related Events
(RARE) Score accurately identifies patients who are at low risk of experiencing
an adverse event while exercise training at cardiac rehabilitation. METHODS:
Individuals screened for entry into cardiac rehabilitation were classified as
high-risk (RARE Score >/= 4) or low-risk (RARE Score < 4) using the RARE Score.
Patients were followed until program completion or withdrawal, and adverse events
were documented. RESULTS: Individuals (n = 656) were eligible for analysis (high
risk: n = 260; low risk: n = 396). Eleven events (1 major, 10 minor) were
recorded during the study, and the overall event rate was low (1 event per 1321
patient hours of exercise training). Individuals triaged as high-risk had
significantly more events than the low-risk cohort (high risk: n = 8 vs low risk:
n = 3; P = .024) and were 4 times more likely to experience an adverse event (OR:
4.2; 95% CI: 1.0-20.0). More than 99% of low-risk patients were event free
(negative predictive value: 99.2%; 95% CI: 98.3-99.8), while participating in
exercise at cardiac rehabilitation. CONCLUSION: The RARE Score accurately
identifies patients who are at low risk of experiencing adverse events during
exercise training at cardiac rehabilitation. The identification of low-risk
patients allows for the possibility of reduced on-site supervision and
monitoring, or the provision of alternative models of cardiac rehabilitation,
including community- or home-based cardiac rehabilitation programs.

Langue : ANGLAIS