Impact of a cardiovascular rehabilitation program on frailty indicators in elderly patients with heart disease
Notice bibliographique
Résumé
Abstract Funding Acknowledgements Type of funding sources: Private hospital(s). Main funding source(s): Hospital Cardio Pulmonar INTRODUCTION Frailty has been considered an important predictor of morbidity and mortality in elderly patients with cardiovascular disease. Cardiovascular Rehabilitation (CVR) has a direct and unequivocal effect on improving functional capacity in patients with heart disease, however, the effect of CVR on frailty indicators has not yet been well established. PURPOSE: To evaluate the association of the CVR program with frailty indicators in elderly patients with heart disease referred to a cardiovascular rehabilitation program and to identify possible predictors of improvement in frailty in this population. METHODS: Retrospective cohort with patients over 65 years old referred to an CVR program in Salvador-BA, Brazil from August / 2017 to March / 2020. Frailty was assessed using the Edmonton Frail Scale (EFS) at baseline and at least 3 months after the start of the program. Student"s t and Chi-square tests were used to compare continuous and categorical variables, respectively, logistic regression to analyze independent predictors of improvement in frailty and p <0.05 adopted as statistically significant. RESULTS: 51 patients were included, with a mean age of 75 ± 6 years, 65% men, 39 (77%) with coronary artery disease, 23 (50%) with heart failure, 21 (41%) with diabetes, 34 (67%) with hypertension and 41 (80%) dyslipidemia. According to the American Heart Association (AHA) risk stratification for exercise, 21 (49%) were risk B and 22 (51%) risk C. Regarding functional capacity, 12 (31%) were class I, 21 (41%) class II, 5 (13%) class III and 1 (3%) class IV according to the New York Heart Association (NYHA). The average initial ejection fraction was 53 ± 16%. The mean time between the two assessments was 5 ± 2 months and the improvement observed in maximum oxygen consumption (VO2 max) was from 15 ± 4 to 16 ± 4 mL.Kg-1.min-1 (p = 0.001). Regarding frailty, there was an improvement from 5.4 ± 2.0 to 4.8 ± 1.9 in the average of the EFS score (p = 0.034), with 25 patients (49%) being considered responders. This group was predominantly formed by men, non-diabetics, using statins, at risk B (AHA) and with a higher score on the quality of life score and on the EFS. However, in the multivariate analysis, only the highest score on the EFS (OR 1.8 CI 95% 1.06-3.3; p <0.05) and the lowest risk on the AHA scale (OR 0.18 CI 95% 0.03-0.97; p <0.05) remained as independent predictors of response. CONCLUSIONS: There was a significant improvement in the frailty of elderly patients referred for CVR, the higher the baseline frailty score, the greater the chance of response.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».