MiscellaneousEffect of Early Enrollment on Outcomes in Cardiac Rehabilitation
Section snippets
Methods
From January 2004 to August 2012, 1,241 consecutive patients were enrolled in the outpatient CR program at Wake Forest Baptist Medical Center within 1 year after interventions for coronary artery disease and/or valvular heart disease, including cardiothoracic surgery. Clinical data for this study were taken from patient records, and the study was approved by our institutional review board.
The details of our CR program have been previously outlined.4 Briefly, it consists of 3 sessions per week
Results
The distribution of time to enrollment in days was as follows: mean = 34.1 ± 34.8, median = 24, interquartile range = 16 to 37, ninety-ninth percentile = 197. Patients who enrolled >30 days after treatment of the index cardiac event were more often women, nonwhite, and older compared with those enrolling within 30 days (p <0.05 vs 0 to 15 days and 16 to 30 days for all comparisons; Table 1). Compared with those enrolling within 15 days, those who enrolled later than 30 days also had a higher
Discussion
As few as 30% of eligible subjects in the US participate in CR.2, 11 The strength of the primary physician's recommendation is a powerful predictor of enrollment,3 but co-morbidities, financial and/or insurance issues, travel times, and occupational considerations are also factors.2, 3, 11 In our study, later enrollees were more likely to be women, nonwhite, and have a lesser income, suggesting social factors also may determine the time to CR participation.
In a previous study of nearly 600
Acknowledgment
We are very grateful to Karen Klein of the Translational Science Institute, Wake Forest University Health Sciences, for editing the manuscript.
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