Abstract
Background: This exploratory observational case–control study investigated the rate of referral to cardiac rehabilitation (CR) among patients hospitalised with heart failure (HF) and identified factors associated with referral. Methods: Patients hospitalised with HF as identified by the Victorian Cardiac Outcomes Registry HF study were included. Factors found to be univariately associated with referral were selected for multivariate logistic regression. Results: Among 1281 patients (mean age: 76.9 years; 32.8% HFrEF and 33.9% HfpEF), 125 (9.8%) were referred to CR. Patients referred were younger (73.6 (2.7, 81.5) vs. 80.2 (71.1, 86.5) p < 0.001) and were more likely to be men (72%, p < 0.001). Factors associated with referral included inpatient percutaneous coronary intervention (OR, 3.31; 95% CI, 1.04–10.48; p = 0.04), an aetiology of ischaemic or rhythm-related cardiomyopathy, and anticoagulants prescribed on discharge. Factors that lowered the likelihood of referral included older age, female, receiving inpatient oxygen therapy, and the presence of chronic obstructive pulmonary disease (COPD) or anaemia. Conclusions: The rate of referral to CR following hospitalisation with HF is low. Shortfalls are particularly evident among females, older patients, and in those with COPD or anaemia. Future studies should focus on improving referral processes and translating proven strategies that increase referrals to CR into practice.
Highlights
Heart failure (HF) is a complex syndrome that affects more than 30 million people worldwide [1,2] and results in significant clinical, functional, and financial costs to individuals and the community [1,3]
This study investigated the rates of referral to cardiac rehabilitation (CR) among patients following hospitalisation with heart failure (HF) in Victoria and identified factors associated with referral and participation
This exploratory observational case–control study is nested within the Victorian Cardiac Outcomes Registry Heart Failure study (VCOR-HF) [15]—a prospective longitudinal cohort study involving patients admitted to Victorian Hospitals with an acute episode of HF
Summary
Heart failure (HF) is a complex syndrome that affects more than 30 million people worldwide [1,2] and results in significant clinical, functional, and financial costs to individuals and the community [1,3]. In Australia, cardiac rehabilitation (CR) offers a supervised program of clinical exercise prescription, education, and risk factor modification to patients with cardiovascular disease. CR is an integral component in the treatment paradigm for HF with evidence consistently demonstrating the reversal of muscle dysfunction and increased aerobic capacity following. This exploratory observational case–control study investigated the rate of referral to cardiac rehabilitation (CR) among patients hospitalised with heart failure (HF) and identified factors associated with referral. Factors that lowered the likelihood of referral included older age, female, receiving inpatient oxygen therapy, and the presence of chronic obstructive pulmonary disease (COPD) or anaemia. Conclusions: The rate of referral to CR following hospitalisation with
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