参加和完成心脏康复治疗的预测因素：对昆士兰心脏结果登记处（2020-2022 年）33,055 名患者的分析。

IF 2.2 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart, Lung and Circulation Pub Date : 2024-11-15 DOI:10.1016/j.hlc.2024.08.002

Emma E Thomas, Michael Le Grande, Samara Phillips, Susie Cartledge, Rohan Poulter, Barbara M Murphy

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引用次数: 0

摘要

目的：心脏康复（CR）服务不足是一项全球性挑战。昆士兰心脏结果登记处是一个全面的临床登记处，定期收集护理点的心脏康复数据。我们旨在确定(i)拒绝接受 CR、(ii)开始接受 CR 但未完成 CR 和(iii)完成 CR 的人群在人口统计学、临床、社会心理和行为特征方面是否存在差异：该队列包括从昆士兰心脏结果登记（2020-2022 年）中提取的转诊至昆士兰 56 家 CR 服务机构之一的 33055 名患者。采用双变量和多变量逻辑回归分析来确定与未参加 CR 和未完成 CR 相关的因素：在研究期间，12,152 名患者（37%）拒绝参加 CR，11,621 名患者（35%）开始参加但未完成 CR，9,282 名患者（28%）完成了 CR。未参加 CR 的重要预测因素包括：年龄≥75 岁（调整后的几率比 [aOR] 1.51；95% 置信区间 [CI] 1.42-1.61）、土著身份（aOR 1.65；95% CI 1.50-1.81）、居住地区（aOR 1.76；95% CI 1.65-1.87）或偏远地区（aOR 2.33；95% CI 1.92-2.82）、心律失常（aOR 2.38；95% CI 2.07-2.73）、心力衰竭（aOR 1.54；95% CI 1.37-1.74）、非 ST 段抬高型心肌梗死（aOR 1.30；95% CI 1.21-1.40）或不稳定型心绞痛（aOR 1.24；95% CI 1.1.13-1.37）。未完成 CR 的重要预测因素是年龄：作为迄今为止关于 CR 参与情况的最大规模研究之一，这些研究结果现在可用于制定有针对性的、共同设计的计划，以提高 CR 的参与率，尤其是在原住民、吸烟者、社会支持有限者、居住在地区/偏远地区的人、心律失常和心力衰竭患者以及不同年龄段的人群中。

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Predictors of Cardiac Rehabilitation Attendance and Completion: Analysis of 33,055 Patients from the Queensland Cardiac Outcomes Registry (2020-2022).

Aim: Cardiac rehabilitation (CR) under-attendance presents a global challenge. The Queensland Cardiac Outcomes Registry is a comprehensive clinical registry that routinely collects point-of-care CR data. We aimed to determine whether demographic, clinical, psychosocial, and behavioural characteristics of the population vary between those who (i) declined, (ii) commenced but did not complete, and (iii) completed CR.

Methods: The cohort comprised 33,055 patients referred to one of 56 Queensland CR services extracted from the Queensland Cardiac Outcomes Registry (2020-2022). Bivariate and multivariable logistic regression analyses were used to identify factors associated with CR non-attendance and non-completion.

Results: Over the study period, 12,152 patients (37%) declined CR, 11,621 (35%) initiated but did not complete CR, and 9,282 (28%) completed CR. Significant predictors of CR non-attendance were aged ≥75 years (adjusted odds ratio [aOR] 1.51; 95% confidence interval [CI] 1.42-1.61), Indigenous status (aOR 1.65; 95% CI 1.50-1.81), living regionally (aOR 1.76; 95% CI 1.65-1.87) or remotely (aOR 2.33; 95% CI 1.92-2.82), and having arrhythmia (aOR 2.38; 95% CI 2.07-2.73), heart failure (aOR 1.54; 95% CI 1.37-1.74), non-ST-elevation myocardial infarction (aOR 1.30; 95% CI 1.21-1.40) or unstable angina (aOR 1.24; 95% CI 1.1.13-1.37). Significant predictors of CR non-completion were age <55 years (aOR 1.55; 95% CI 1.37-1.75), Indigenous status (aOR 1.60; 95% CI 1.29-1.98), living regionally (aOR 1.29; 95% CI 1.12-1.48), obesity (aOR 1.14; 95% CI 1.01-1.28), being a current (aOR 1.97; 95% CI 1.70-2.27) or former smoker (aOR:1.22, 95% CI 1.11-1.33) and having low social support (aOR 1.58; 95% CI 1.24-2.02).

Conclusion: As one of the largest studies of CR participation to date, these findings can now be applied to develop targeted, co-designed initiatives to enhance CR participation, especially among First Nations populations, smokers, those with limited social support, people living regionally/remotely, patients with arrhythmia and heart failure, and those in varying age groups.

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来源期刊

Heart, Lung and Circulation CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.50

自引率

3.80%

发文量

912

审稿时长

11.9 weeks

期刊介绍： Heart, Lung and Circulation publishes articles integrating clinical and research activities in the fields of basic cardiovascular science, clinical cardiology and cardiac surgery, with a focus on emerging issues in cardiovascular disease. The journal promotes multidisciplinary dialogue between cardiologists, cardiothoracic surgeons, cardio-pulmonary physicians and cardiovascular scientists.