Attendance rates and outcomes of cardiac rehabilitation in Victoria, 1998

• Published in: Medical journal of Australia Vol. 180; no. 6; pp. 268 - 271
• Main Authors: Sundararajan, Vijaya, Begg, Stephen, Marshall, Ric, Bunker, Stephen J, McBurney, Helen
• Format: Journal Article
• Language: English
• Published: Sydney Australasian Medical Publishing Company 15-03-2004; Australasian Medical Publishing Company Proprietary, Ltd
• Subjects: Adult; Age; Aged; Aged, 80 and over; Angioplasty; Angioplasty, Balloon, Coronary - mortality; Angioplasty, Balloon, Coronary - rehabilitation; Biological and medical sciences; Cardiovascular diseases; Coronary Artery Bypass - mortality; Coronary Artery Bypass - rehabilitation; Coronary Disease - mortality; Coronary Disease - rehabilitation; Coronary Disease - surgery; Datasets; Exercise; Female; General aspects; Health surveillance; Heart attacks; Hospitals; Humans; Logistic Models; Male; Medical Record Linkage; Medical sciences; Middle Aged; Multivariate Analysis; Myocardial Infarction - mortality; Myocardial Infarction - rehabilitation; Patient Acceptance of Health Care; Proportional Hazards Models; Prospective Studies; Regression analysis; Rehabilitation; Survival Rate; Victoria - epidemiology; Australia; Oceania; Victoria; Heart; Human; Medicine; Cardiovascular disease; Evolution; Reeducation
• ISSN: 0025-729X; 1326-5377
• DOI: 10.5694/j.1326-5377.2004.tb05923.x

Objective: To describe the patterns of use of cardiac rehabilitation in Victoria and to assess whether the survival benefits predicted in clinical trials have been realised in the community.
Design: Cohort study based on data linkage.
Participants: All patients admitted for acute myocardial infarction (AMI), coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA) in Victoria in 1998 (n = 12 821).
Interventions: Attendance at one of 66 participating outpatient cardiac rehabilitation centres in Victoria.
Main outcome measures: Rates of attendance at rehabilitation based on key factors such as diagnosis, age, sex, and comorbidity. Five‐year survival for attendees compared with non‐attendees.
Results: Rates of participation in rehabilitation were 15% for AMI, 37% for CABG, and 14% for PTCA. Rehabilitation attendance rates dropped sharply after 70 years of age. Attendees had a 35% improvement in 5‐year survival (hazard ratio for death associated with rehabilitation attendance, 0.65 [95% CI, 0.56–0.75]).
Conclusions: Attendance rates at cardiac rehabilitation are suboptimal, even though attendance confers a clinically significant difference in 5‐year survival. The elderly, women, and those with comorbid conditions may benefit measurably from increased rates of attendance.