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Readmission after cardiac rehabilitation program in a tertiary hospital
Background: The purpose of this research is to describe the clinical characteristics of people admitted to a cardiac rehabilitation program (CRP) after an acute coronary syndrome (ACS) and analyze what risk factors are related with an increased risk of readmission. Methods: Descriptive study of patients admitted between January 2012 and May 2015 in the CRP of a tertiary hospital, to determine epidemiological characteristics and prevalence of cardiovascular risk factors. Also, analytical study of risk factors for readmission in this group of patients. Personal history of each patient were consulted and compared the risk of readmission according to: LVEF<50%, incomplete revascularization, arterial hypertension(AHT), dyslipidemia(DLP), diabetes mellitus(DM), atrial fibrillation, sex, age and to have completed cardiac rehabilitation program. Results: During the study period, 517 patients were admitted to the CRP, 80.3% were men (mean age 57.81±8.18) and 19.7% women (mean age 56.76±9.06). The most frequent diagnosis were STEMI (52.4%) and unstable angina (24.2%). When we analyze the different risk factors in this group of patients, the results show us that that AHT(p=0.003, OR 2.3, CI95% 1.3-2.9), DLP(p=0.001, OR 2.78, CI95% 1.5-5), DM (p=0.02, OR 1.84, CI95% 1.0-3.1), and incomplete revascularization (p=0.045, OR 1.71, CI95% 1.0-2.9) were related to an increased risk of readmission. Conclusion: As we showed in our study, 3 of the 4 risk factors associated with readmmission were modifiable risk factors (AHT, DLP and DM) and this results reinforce the need for control these with the optimization of drug therapies and promoting healthy habits. Readmission was also more frequent in patients who did not complete the CRP and in patients with LVEF<50% but the difference was not statistically significant.
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