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Inpatient cardiac rehabilitation

Samuel G Wittekind, Yvette Gerdes, Wayne Mays, Clifford Chin, John L Jefferies
Nonischemic dilated cardiomyopathy is deadly and costly, and treatment options are limited. Cardiac rehabilitation has proved safe and beneficial for adults with various types of heart failure. Therefore, we retrospectively evaluated the hypothesis that rehabilitation is safe and improves cardiometabolic health in young patients with nonischemic dilated cardiomypathy. From 2011 through 2015, 8 patients (4 males) (mean age, 20.6 ± 6.6 yr; range, 10-31 yr) underwent rehabilitation at our institution. They were in American Heart Association class C or D heart failure and were on maximal medical therapy...
February 2018: Texas Heart Institute Journal
Katharina Kähm, Michael Laxy, Udo Schneider, Wolf H Rogowski, Stefan K Lhachimi, Rolf Holle
OBJECTIVE: The aim of this study is to provide reliable regression-based estimates of costs associated with different type 2 diabetes complications. RESEARCH DESIGN AND METHODS: We used nationwide statutory health insurance (SHI) data from 316,220 patients with type 2 diabetes. Costs for inpatient and outpatient care, pharmaceuticals, rehabilitation, and nonmedical aids and appliances were assessed in the years 2013-2015. Quarterly observations are available for each year...
January 18, 2018: Diabetes Care
A Schlitt, M Guha, M Noutsias, H H Klein, H U Klein
Assessment of a permanent risk of life-threatening ventricular arrhythmia in patients with severely reduced left ventricular ejection fraction (LVEF <35%), e. g. after myocarditis, dilated cardiomyopathy, acute myocardial infarction, in patients with postpartum cardiomyopathy or implantable cardioverter-defibrillator (ICD) and cardiac resynchronization treatment plus defibrillator (CRT-D) infection with temporary explantation of the system is a medical challenge. This is time-consuming and unsafe because life-threatening ventricular arrhythmias may occur during the time of risk assessment...
December 12, 2017: Herz
Fergus William Gardiner, Ezekiel Uba Nwose, Phillip Taderera Bwititi, Judith Crockett, Lexin Wang
There is a large number of patients with chronic kidney disease (CKD), diabetes mellitus (DM), and hypertension (HT) but whether the targets on blood pressure (BP) control in patients with DM and/or CKD are met is not clear. This narrative review therefore investigated evidence on services aimed at achieving desirable clinical results in patients with CKD and DM, and HT in Australia. Literature pertaining to pathology diagnosis and management of these patients as well as the complexities in management were considered...
2017: SAGE Open Medicine
Rita Fuchs-Strizek, Thomas Berger
Psychosocial risk factors contribute to the development and progression of cardiovascular diseases. They are associated with an unhealthy lifestyle, low patient adherence, alterations in autonomic function and endocrine markers. Thus, in cardiac rehabilitation, psychosocial risk factors should be assessed besides somatic factors. Patients with clinically significant symptoms ought to be referred for further psychological diagnostics. Depending on the findings, patients should be offered psychological interventions like relaxation training, stress management courses, smoking cessation programmes and individual counselling...
October 26, 2017: Wiener Medizinische Wochenschrift
Bahar Boydak
As it is the case globally, cardiovascular diseases (CVD) make up the most frequent cause of death in Turkey also. Due to this fact, cardiac rehabilitation (CR) has gained a highly important role in the treatment of coronary artery diseases. In Turkey, mortality and morbidity rates among the elderly patients are significantly high. Disability due to coronary artery diseases is more frequent in the elderly compared to young patients. So, it is clear that CR has a considerable importance in this special group of patients...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Richard P Menger, Piyush Kalakoti, Andrew J Pugely, Anil Nanda, Anthony Sin
OBJECTIVE Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis. Limited literature exists defining risk factors associated with outcomes during initial hospitalization in these patients. In this study, the authors investigated patient demographics, clinical and hospital characteristics impacting short-term outcomes, and costs in adolescent patients undergoing surgical deformity correction for idiopathic scoliosis. Additionally, the authors elucidate the impact of hospital surgical volume on outcomes for these patients...
October 2017: Neurosurgical Focus
Ana Isabel Penzlin, Kristian Barlinn, Ben Min-Woo Illigens, Kerstin Weidner, Martin Siepmann, Timo Siepmann
BACKGROUND: A randomized controlled study (RCT) recently showed that short-term heart rate variability (HRV) biofeedback in addition to standard rehabilitation care for alcohol dependence can reduce craving, anxiety and improve cardiovascular autonomic function. In this one-year follow-up study we aimed to explore whether completion of 2-week HRV-Biofeedback training is associated with long-term abstinence. Furthermore, we sought to identify potential predictors of post-treatment abstinence...
September 6, 2017: BMC Psychiatry
Lindsay E Jubelt, Keith S Goldfeld, Saul B Blecker, Wei-Yi Chung, John A Bendo, Joseph A Bosco, Thomas J Errico, Anthony K Frempong-Boadu, Richard Iorio, James D Slover, Leora I Horwitz
INTRODUCTION: Orthopaedic care is shifting to alternative payment models. We examined whether New York University Langone Medical Center achieved savings under the Centers for Medicare and Medicaid Services Bundled Payments for Care Improvement initiative. METHODS: This study was a difference-in-differences study of Medicare fee-for-service patients hospitalized from April 2011 to June 2012 and October 2013 to December 2014 for lower extremity joint arthroplasty, cardiac valve procedures, or spine surgery (intervention groups), or for congestive heart failure, major bowel procedures, medical peripheral vascular disorders, medical noninfectious orthopaedic care, or stroke (control group)...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
Vinay Guduguntla, John D Syrjamaki, Chad Ellimoottil, David C Miller, Richard L Prager, Edward C Norton, Patricia Theurer, Donald S Likosky, James M Dupree
Importance: Coronary artery bypass grafting (CABG) is scheduled to become a mandatory Medicare bundled payment program in January 2018. A contemporary understanding of 90-day CABG episode payments and their drivers is necessary to inform health policy, hospital strategy, and clinical quality improvement activities. Furthermore, insight into current CABG payments and their variation is important for understanding the potential effects of bundled payment models in cardiac care. Objective: To examine CABG payment variation and its drivers...
August 23, 2017: JAMA Surgery
Lee Anne Siegmund, Haitham M Ahmed, Michael Todd Crawford, James Frank Bena
BACKGROUND: While cardiac rehabilitation has been shown to be effective at improving coronary heart disease (CHD), participation is generally poor. Attempts to increase uptake and adherence often fail. Use of a Facebook intervention for this population may be a unique opportunity to support self-determined motivation and affect adherence. OBJECTIVE: To evaluate the impact of a Facebook intervention on motivation for exercise and adherence to cardiac rehabilitation in patients with CHD during a 12-week, Phase II cardiac rehabilitation program...
August 18, 2017: JMIR Research Protocols
Ines Frederix, Dominique Vandijck, Niel Hens, Johan De Sutter, Paul Dendale
BACKGROUND: Cardiac rehabilitation for ischaemic heart disease effectively reduces cardiovascular readmission rate and mortality. Current uptake rates however, remain low. This study assesses the social and economic impact of increasing centre-based cardiac rehabilitation uptake and the additional value of cardiac telerehabilitation using cost-benefit analysis (CBA) in Belgium. METHODS: Cost-benefit analysis was conducted to analyse three scenarios: (1) current situation: 20% uptake rate of cardiac rehabilitation; (2) alternative scenario one: 40% uptake rate of cardiac rehabilitation; and (3) alternative scenario two: 20% uptake of cardiac rehabilitation and 20% uptake of both cardiac rehabilitation and telerehabilitation...
August 11, 2017: Acta Cardiologica
Debora Fedele, Virginia Bicchiega, Alessandro Collo, Federica Barutta, Erika Pistone, Gabriella Gruden, Graziella Bruno
AIM: Natriuretic peptides are not only involved in cardiovascular adaption to various conditions, but also in metabolic diseases. We performed this study to assess the effect of a very short time of lifestyle inpatient intervention on NTproBNP values in normotensive subjects with severe obesity and normal cardiac function. METHODS: We recruited 14 consecutive obese normotensive subjects with normal cardiac function who were aged 30 years and more and were referred to inpatient rehabilitation in an academic clinic over a two months period...
2017: PloS One
Dieter Benninghoven, Denise Hamann, Yskert von Kodolitsch, Meike Rybczynski, Julia Lechinger, Friedrich Schroeder, Marina Vogler, Eike Hoberg
BACKGROUND: Advances in medical, interventional and surgical treatment have increased average life expectancy of patients with congenital heart defects. As a result a new group of adult patients with congenital cardiac defects requires medical rehabilitation. Patients with Marfan syndrome (MFS) are a relevant group among these patients. So far, no reports on the effectiveness of specialized rehabilitation programmes for MFS patients exist. We implemented an inpatient 3-week rehabilitation program for MFS patients at the Muehlenberg-Clinic for rehabilitation and assessed the medical safety as well as the impact of the program on physical fitness and psychological wellbeing of participants by means of an observational pilot study...
July 12, 2017: Orphanet Journal of Rare Diseases
Jason L Rengo, Patrick D Savage, Trace Barrett, Philip A Ades
PURPOSE: Exercise training has been shown to reduce combined cardiovascular mortality and hospitalizations in patients with chronic heart failure (CHF) with reduced ejection fraction (HFrEF). Whereas there are extensive data on exercise training for individuals with HFrEF in a research setting, the experience of delivering cardiac rehabilitation (CR) services in the clinical setting has not been well described. With little knowledge regarding the number of qualifying patients with HFrEF in the United States, we described our 18-month experience recruiting hospitalized inpatients and stable outpatients into phase 2 CR...
June 30, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
Melissa D Zullo, Mary A Dolansky, Richard A Josephson, Vinay K Cheruvu
PURPOSE: Older adults who use postacute care (PAC) after hospitalization for myocardial infarction (MI) are often overlooked as cardiac rehabilitation (CR) candidates because of physical limitations. This research describes the impact of functional status and PAC, including inpatient rehabilitation facility (IRF), skilled nursing facility (SNF), or home health care (HHC), on CR initiation in Medicare beneficiaries discharged from the hospital following an index MI. METHODS: The Chronic Condition Warehouse database of Medicare beneficiaries discharged to PAC following index MI in 2008 (n = 63 092) was used for this retrospective study...
January 2018: Journal of Cardiopulmonary Rehabilitation and Prevention
Yong Gon Seo, Won Hah Park, Eun Seok Jeon, Ji Dong Sung, Mi Ja Jang
Left ventricular assist devices (LVADs) are used in patients with progressive heart failure symptoms to provide circulatory support. Patients with LVADs are referred to inpatient cardiac rehabilitation to prevent postoperative complications and improve aerobic capacity and quality of life. Preoperative exercise therapy for cardiac patients is an emerging treatment modality, and several studies have reported that it improves postoperative outcomes, such as length of hospital stay and postoperative complications...
June 19, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
Amanda L Bennett, Carl J Lavie, Sherry L Grace
Acute coronary syndrome (ACS) is among the leading burdens of disease among women. It is a significant driver of morbidity and chronically undermines their quality of life. Cardiac rehabilitation (CR) is indicated for ACS patients in clinical practice guidelines, including those specifically for women. CR is a multi-component model of care, proven to reduce mortality and morbidity, including in women. However, women are significantly less likely to be referred to CR by providers, and if they are referred, to enroll and adhere to programs...
August 2017: Current Treatment Options in Cardiovascular Medicine
Thomas Schmidt, Birna Bjarnason-Wehrens, Petra Bartsch, Ezin Deniz, Jan Schmitto, Sebastian Schulte-Eistrup, Detlev Willemsen, Nils Reiss
Adequate physical and functional performance is an important prerequisite for renewed participation and integration in self-determined private and (where appropriate) professional lives following left ventricular assist device (LVAD) implantation. During cardiac rehabilitation (CR), individually adapted exercise programs aim to increase exercise capacity and functional performance. A retrospective analysis of cardiopulmonary exercise capacity and functional performance in LVAD patients at discharge from a cardiac rehabilitation program was conducted...
June 16, 2017: Artificial Organs
Natsuko Kanazawa, Kenji Ueshima, Shinjiro Tominari, Takeo Nakayama
BACKGROUND: Workers with coronary artery disease (CAD) require evidence-based care in order to return to work safely. We assessed the use of cardiac rehabilitation (CR) among workers with CAD, and identified the factors associated with CR use.Methods and Results:A retrospective cohort study based on data from a health insurance claims database was conducted. We identified workers aged ≥18 years who underwent percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) between 2006 and 2013, and reviewed the utilization of inpatient or outpatient CR...
September 25, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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