Jorge Montero-Cámara, Francisco José Ferrer-Sargues, David Cuesta Peredo, Adrián Sarria Cabello, María José Segrera Rovira, Juan Antonio Margarit Calabuig, Noemí Valtueña-Gimeno, Juan Pardo, María Luz Sánchez-Sánchez
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引用次数: 0
Abstract
Background and purpose: Cardiac surgery enhances cardiovascular disease (CVD) patient survival rates, and the fast-track protocol can reduce complications, hospital length of stay (HLOS) and associated costs. However, there is no evidence on the effectiveness of unsupervised physiotherapy programmes in reducing HLOS and postoperative pulmonary complications in patients undergoing fast-track surgery. The study aimed to determine if a pre-surgical respiratory programme reduces intensive care unit length of stay (ICULOS) and HLOS patients undergoing fast-track surgery, and its effects on post-operative complications and healthcare costs.
Methods: This was a retrospective observational cohort study. The patients were divided into two groups: those who followed the exercise programme (pre-hab group) and those who did not (no pre-hab group). The study analysed the mean of ICULOS and HLOS for each group, recorded post-operative complications, and calculated healthcare costs using the Spanish Ministry of Health cost tables.
Results: A total of 418 patients participated in the study with a mean age of 70.44 (10.87) years. The study found significant differences in HLOS (p = 0.001) and ICULOS (p = 0.003) between groups. Pre-hab HLOS was 232.8 (221.3) hours in the hospital, whereas no pre-hab LOS increased to 315.1 (277.9) hours. Pre-hab ICULOS was 82.0 (129.8) hours when No pre-hab ICULOS accounted 120.2 (190.3) hours. This reduction in hospital admissions resulted in savings of €356,107.16 in average healthcare costs for the pre-hab group. Mortality risk (p = 0.034) was also reduced in the pre-hab group (17.7% vs. 26.65% in the no pre-hab group).
Discussion: An unsupervised home-based respiratory programme reduces hospital and ICU stay, healthcare costs, post-surgical pulmonary complications, and mortality risk. The clinical application of an unsupervised home-based pre-habilitation programme, focussing on ventilatory exercises and costal expansion techniques, has proven effective in enhancing patient recovery post-cardiac surgery, offering significant healthcare cost savings, and reducing the burden on hospital resources.
期刊介绍：
Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.
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