Cardiac rehabilitation: health characteristics and socio-economic status among those who do not attend

Kirsten M Nielsen, Ole Faergeman, Anders Foldspang, Mogens L Larsen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Udgivelsesdato: 2008-Oct
OriginalsprogEngelsk
TidsskriftEuropean Journal of Public Health
Vol/bind18
Udgave nummer5
Sider (fra-til)479-83
Antal sider4
ISSN1101-1262
DOI
StatusUdgivet - 1. okt. 2008

Fingeraftryk

Health
Cardiac Rehabilitation
Patient Selection
Registries
Electrocardiography
Logistic Models

Citer dette

Nielsen, Kirsten M ; Faergeman, Ole ; Foldspang, Anders ; Larsen, Mogens L. / Cardiac rehabilitation: health characteristics and socio-economic status among those who do not attend. I: European Journal of Public Health. 2008 ; Bind 18, Nr. 5. s. 479-83.
@article{fcdcf460e88b11dd990d000ea68e967b,
title = "Cardiac rehabilitation: health characteristics and socio-economic status among those who do not attend",
abstract = "BACKGROUND: Cardiac rehabilitation (CR) is well documented, in randomised trials, to reduce mortality risk after myocardial infarction (MI). Selection of healthy patients for CR is a relatively unexplored problem. Our aims were to identify predictors of CR-attendance and to describe the prognosis as concerns mortality, re-admission and invasive treatment among CR-attendees as compared to CR-non-attendees. Methods: From a cohort of 138 290 persons aged 30-69 years, we identified consecutive MI patients, between 1 April 2000 and 31 March 2002. There were 206 MI patients, who survived until admission, and among the 200 who survived 30 days, 145 (72.5{\%}) attended a comprehensive CR programme. Data were obtained from patient charts and from Danish population registers, and as a result we had no non-participation for the study. RESULTS: The 2-year mortality proportions for patients surviving the first 30 days of admission were 2.8 and 21.8{\%} among CR-attendees and CR-non-attendees, respectively (P < 0.0001). Among CR-non-attendees, there was a smaller fraction having an invasive treatment performed as compared with CR-attendees. By multiple logistic regression controlling for age and sex, CR-attendance was associated with chest pain, whereas CR-non-attendance was associated with low gross income, single living and inverted T-wave in the electrocardiogram. CONCLUSION: CR attendance rate was 72.5{\%}. Non-attendees have a higher mortality risk, which in part may be attributed to selection of healthy patients. Non-attendees are older and more likely to have atypical symptoms at admission, a low socioeconomic status and to live alone. Special attention is needed to improve CR attendance among such patients.",
keywords = "Adult, Aged, Cohort Studies, Denmark, Female, Humans, Male, Middle Aged, Myocardial Infarction, Patient Compliance, Social Class",
author = "Nielsen, {Kirsten M} and Ole Faergeman and Anders Foldspang and Larsen, {Mogens L}",
year = "2008",
month = "10",
day = "1",
doi = "10.1093/eurpub/ckn060",
language = "English",
volume = "18",
pages = "479--83",
journal = "European Journal of Public Health",
issn = "1101-1262",
publisher = "Heinemann",
number = "5",

}

Cardiac rehabilitation: health characteristics and socio-economic status among those who do not attend. / Nielsen, Kirsten M; Faergeman, Ole; Foldspang, Anders; Larsen, Mogens L.

I: European Journal of Public Health, Bind 18, Nr. 5, 01.10.2008, s. 479-83.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Cardiac rehabilitation: health characteristics and socio-economic status among those who do not attend

AU - Nielsen, Kirsten M

AU - Faergeman, Ole

AU - Foldspang, Anders

AU - Larsen, Mogens L

PY - 2008/10/1

Y1 - 2008/10/1

N2 - BACKGROUND: Cardiac rehabilitation (CR) is well documented, in randomised trials, to reduce mortality risk after myocardial infarction (MI). Selection of healthy patients for CR is a relatively unexplored problem. Our aims were to identify predictors of CR-attendance and to describe the prognosis as concerns mortality, re-admission and invasive treatment among CR-attendees as compared to CR-non-attendees. Methods: From a cohort of 138 290 persons aged 30-69 years, we identified consecutive MI patients, between 1 April 2000 and 31 March 2002. There were 206 MI patients, who survived until admission, and among the 200 who survived 30 days, 145 (72.5%) attended a comprehensive CR programme. Data were obtained from patient charts and from Danish population registers, and as a result we had no non-participation for the study. RESULTS: The 2-year mortality proportions for patients surviving the first 30 days of admission were 2.8 and 21.8% among CR-attendees and CR-non-attendees, respectively (P < 0.0001). Among CR-non-attendees, there was a smaller fraction having an invasive treatment performed as compared with CR-attendees. By multiple logistic regression controlling for age and sex, CR-attendance was associated with chest pain, whereas CR-non-attendance was associated with low gross income, single living and inverted T-wave in the electrocardiogram. CONCLUSION: CR attendance rate was 72.5%. Non-attendees have a higher mortality risk, which in part may be attributed to selection of healthy patients. Non-attendees are older and more likely to have atypical symptoms at admission, a low socioeconomic status and to live alone. Special attention is needed to improve CR attendance among such patients.

AB - BACKGROUND: Cardiac rehabilitation (CR) is well documented, in randomised trials, to reduce mortality risk after myocardial infarction (MI). Selection of healthy patients for CR is a relatively unexplored problem. Our aims were to identify predictors of CR-attendance and to describe the prognosis as concerns mortality, re-admission and invasive treatment among CR-attendees as compared to CR-non-attendees. Methods: From a cohort of 138 290 persons aged 30-69 years, we identified consecutive MI patients, between 1 April 2000 and 31 March 2002. There were 206 MI patients, who survived until admission, and among the 200 who survived 30 days, 145 (72.5%) attended a comprehensive CR programme. Data were obtained from patient charts and from Danish population registers, and as a result we had no non-participation for the study. RESULTS: The 2-year mortality proportions for patients surviving the first 30 days of admission were 2.8 and 21.8% among CR-attendees and CR-non-attendees, respectively (P < 0.0001). Among CR-non-attendees, there was a smaller fraction having an invasive treatment performed as compared with CR-attendees. By multiple logistic regression controlling for age and sex, CR-attendance was associated with chest pain, whereas CR-non-attendance was associated with low gross income, single living and inverted T-wave in the electrocardiogram. CONCLUSION: CR attendance rate was 72.5%. Non-attendees have a higher mortality risk, which in part may be attributed to selection of healthy patients. Non-attendees are older and more likely to have atypical symptoms at admission, a low socioeconomic status and to live alone. Special attention is needed to improve CR attendance among such patients.

KW - Adult

KW - Aged

KW - Cohort Studies

KW - Denmark

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Myocardial Infarction

KW - Patient Compliance

KW - Social Class

U2 - 10.1093/eurpub/ckn060

DO - 10.1093/eurpub/ckn060

M3 - Journal article

C2 - 18614608

VL - 18

SP - 479

EP - 483

JO - European Journal of Public Health

JF - European Journal of Public Health

SN - 1101-1262

IS - 5

ER -