Influence of Age on Rehabilitation Outcomes and Survival in Post-Acute Inpatient Cardiac Rehabilitation

Abstract

To investigate the relationship of increasing age to clinical characteristics, rehabilitation outcomes, and long-term survival in a post-acute inpatient cardiac rehabilitation program. The study population consisted of all 364 consecutive cardiac rehabilitation patients admitted over a 4-year period to an inpatient cardiac rehabilitation program in a long-term acute care hospital.Admission and discharge comparisons were made between 3 age cohorts: 65 years (n = 117), 65 to 74 years (n = 127), and ≥ 75 years (n = 120). Patients were followed through January, 2010 for survival. The 3 cohorts on admission differed significantly in Functional Independence Measure, estimated Glomerular Filtration Rate, smoking and hypertension histories, body mass index, and cardiac diagnoses (all P < .05) but not in Simplified Acute Physiology Score II, Cumulative Illness Rating Scale for Geriatrics, or left ventricular ejection fraction. There were no cohort differences in rehabilitation outcomes of physical function, inpatient days, and discharge disposition. Survival was longest in the youngest cohort whereas the 2 older cohorts had similar survivals (P < .01; log-rank test). All 3 cohorts had at least 40% survival at 8 years. Cox regression analyses showed that the comorbidity burden as quantified by the Cumulative Illness Rating Scale for Geriatrics was the only predictor of death in all cohorts (all P ≤ .002). This study provided evidence that post-acute inpatient cardiac rehabilitation programs equally benefited both elderly patients and younger patients. These programs are valuable in the continuum of care for elderly patients who are not yet ready for discharge to home following a serious cardiac event.