PMID- 34850879 OWN - NLM STAT- MEDLINE DCOM- 20221121 LR - 20221228 IS - 2058-1742 (Electronic) IS - 2058-1742 (Linking) VI - 8 IP - 8 DP - 2022 Nov 17 TI - Cardiac rehabilitation for patients with heart failure: association with readmission and mortality risk. PG - 830-839 LID - 10.1093/ehjqcco/qcab086 [doi] AB - AIMS: To examine the temporal trends and factors associated with national cardiac rehabilitation (CR) referral and compare the risk of hospital readmission and mortality in those referred for CR versus no referral. METHODS AND RESULTS: This cohort study includes all adult patients alive 120 days from incident heart failure (HF) identified by the Danish Heart Failure Registry (n = 33 257) between 2010 and 2018. Multivariable logistic regression models were used to assess the association between CR referral and patient factors and acute all-cause hospital readmission and mortality at 1 year following HF admission. Overall, 46.7% of HF patients were referred to CR, increasing from 31.7% in 2010 to 52.2% in 2018. Several factors were associated with lower odds of CR referral: male sex [odds ratio (OR): 0.85; 95% confidence interval: 0.80-0.89], older age, unemployment, retirement, living alone, non-Danish ethnic origin, low educational level, New York Heart Association (NYHA) class IV vs. I (OR: 0.75; 0.60-0.95), left ventricular ejection fraction >40%, and comorbidity (stroke, chronic kidney disease, atrial fibrillation/flutter, and diabetes). Myocardial infarction, arthritis, coronary artery bypass grafting, percutaneous coronary intervention, valvular surgery, NYHA class II, and use of angiotensin-converting enzyme inhibitors were associated with higher odds of CR referral. CR referral was associated with lower risk of acute all-cause readmission (OR: 0.92; 0.87-0.97) and all-cause mortality (OR: 0.65; 0.58-0.72). CONCLUSION: Although increased over time, only one in two HF patients in Denmark were referred to CR in 2018. Strategies are needed to reduce referral disparities, focusing on subgroups of patients at highest risk of non-referral. CI - (c) The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology. FAU - Thygesen, Lau Caspar AU - Thygesen LC AD - National Institute of Public Health, University of Southern Denmark, Studiestraede 6, DK-1455 Copenhagen, Denmark. FAU - Zinckernagel, Line AU - Zinckernagel L AD - National Institute of Public Health, University of Southern Denmark, Studiestraede 6, DK-1455 Copenhagen, Denmark. FAU - Dalal, Hasnain AU - Dalal H AD - University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, UK. AD - Primary Care Research Group, University of Exeter Medical School, St Luke's Campus, Exeter, UK. FAU - Egstrup, Kenneth AU - Egstrup K AD - Department of Cardiovascular Research, Odense University Hospital, Svendborg, Denmark. FAU - Glumer, Charlotte AU - Glumer C AD - Center for Diabetes in the City of Copenhagen, Copenhagen, Denmark. FAU - Gronbaek, Morten AU - Gronbaek M AD - National Institute of Public Health, University of Southern Denmark, Studiestraede 6, DK-1455 Copenhagen, Denmark. FAU - Holmberg, Teresa AU - Holmberg T AD - National Institute of Public Health, University of Southern Denmark, Studiestraede 6, DK-1455 Copenhagen, Denmark. FAU - Kober, Lars AU - Kober L AD - Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - la Cour, Karen AU - la Cour K AD - Department of Public Health, University of Southern Denmark, Odense, Denmark. FAU - Nakano, Anne AU - Nakano A AD - The Danish Clinical Registries (RKKP), Aarhus. Denmark. FAU - Nielsen, Claus Vinther AU - Nielsen CV AD - Institute of Public Health, Aarhus University, Aarhus, Denmark. AD - DEFACTUM, Central Denmark Region, Aarhus, Denmark. AD - Regional Hospital West Jutland, Herning, Denmark. FAU - Sibilitz, Kirstine Laerum AU - Sibilitz KL AD - Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Tolstrup, Janne Schurmann AU - Tolstrup JS AD - National Institute of Public Health, University of Southern Denmark, Studiestraede 6, DK-1455 Copenhagen, Denmark. FAU - Zwisler, Ann Dorthe AU - Zwisler AD AD - REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Nyborg, Denmark. FAU - Taylor, Rod S AU - Taylor RS AD - National Institute of Public Health, University of Southern Denmark, Studiestraede 6, DK-1455 Copenhagen, Denmark. AD - Institute of Health and Well Being, University of Glasgow, Glasgow, UK. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - England TA - Eur Heart J Qual Care Clin Outcomes JT - European heart journal. Quality of care & clinical outcomes JID - 101677796 SB - IM CIN - Eur Heart J Qual Care Clin Outcomes. 2022 Jun 6;8(4):478. PMID: 35030238 MH - Adult MH - Humans MH - Male MH - *Cardiac Rehabilitation MH - Stroke Volume MH - Cohort Studies MH - Patient Readmission MH - Ventricular Function, Left MH - *Heart Failure OTO - NOTNLM OT - Cardiac rehabilitation OT - Guideline adherence OT - Heart failure OT - Registries OT - Secondary prevention EDAT- 2021/12/02 06:00 MHDA- 2022/11/22 06:00 CRDT- 2021/12/01 08:50 PHST- 2021/09/16 00:00 [received] PHST- 2021/11/08 00:00 [revised] PHST- 2021/11/17 00:00 [accepted] PHST- 2021/12/02 06:00 [pubmed] PHST- 2022/11/22 06:00 [medline] PHST- 2021/12/01 08:50 [entrez] AID - 6446806 [pii] AID - 10.1093/ehjqcco/qcab086 [doi] PST - ppublish SO - Eur Heart J Qual Care Clin Outcomes. 2022 Nov 17;8(8):830-839. doi: 10.1093/ehjqcco/qcab086.