P494 FRAILTY INFLUENCE ON PHYSICAL AND PSYCHOLOGICAL OUTCOMES IN POST–CARDIAC SURGERY PATIENTS CARDIAC REHABILITATION, A SINGLE CENTER STUDY

Abstract

Abstract Cardiac rehabilitation (CR) is a clinically and cost–effective intervention in post–cardiac surgery patients (PCSp). However the influence of patients frailty on clinical and psychological outcomes in these patients are not well–known. The aim of our work was to evaluate the effectiveness of a personalized rehabilitative therapy in PCSp divided using the Cumulative Illness Rating Scale (CIRS) in group A (393 low–frail pts, CIRS <3, 230 M, 65±3 yrs) and in a Group B (540 frail pts, CIRS >4, 379 M, 67±10) ) evaluating pre and post–treatment the degree of autonomy recovery (Six–minute walking test SMWT, Barthel Index, BI) and the psychological behaviour (State–Trait Anxiety Inventory STAI–X1, Depression Questionaire QD–R). At admission the comparison between Group A vs B has show: a greater loss autonomy in frail patients (BI scale A 51.7±1 vs B 28.7±14, p 0.005; SMWT A 245±25 m vs B 155±18 m, p 0.005) a greater impairment in psychological characteristics in frail patients (STAI–X1 A 18±9 vs B 20±4 p 0.028, QD/R A 3.6±2 vs B4.4±3 p0.001) At discharge after a similar period of rehabilitation (A 24.7±11.8 days vs B 25.6±10 days, p ns) we observed: a more evident improvement of degree of autonomy recovery in low–frai group ((BI scale A 77.7±18 vs B 67.7±19, p 0.001; SMWT A 485±18 m vs B 341±25m, p 0.001) a similar improvement in anxiety and depression characteristic in both groups (STAI–X1 A 17.8±2 vs B 17.4±4 p ns, QD/R A 3.1±2 vs B 3.4±2 p ns) Conclusions In our experience the frailty status does not affect the cardiac rehabilitation in post–cardiac surgery patients in term of ensuring adequate functional recovery (although reduced compared to low–frail patients) but with similar improvement in psychological behaviours.