Clinical and Functional Predictors of Health-Related Quality of Life During Cardiac Rehabilitation

PURPOSE: This is a retrospective and descriptive analysis of demographic and clinical factors common among cardiac rehabilitation patients with high versus low perceptions of health-related quality of life (HRQOL). In addition, we describe the characteristics that are predictive of greater improvements in HRQOL during cardiac rehabilitation. METHODS: We included 970 patients (63.6 +/- 10.6 years; 71% male patients) referred to a 12-week program between 1996 and 2006 who all completed a HRQOL questionnaire at baseline and program completion. Patients were divided into 4 quartiles based on HRQOL scores at program entry. The Kruskall-Wallis test and chi(2) analyses determined differences between quartiles for continuous and categorical variables, respectively. In addition, regression models predicted changes in HRQOL during the course of the cardiac rehabilitation program. RESULTS: At program entry, quartile differences were found for diagnosis (P = .04), number of risk factors (P < .01), self-efficacy (P < .001), and caloric expenditure (P = .05). Significant predictors of change included baseline HRQOL sores, flexibility, and left ventricular ejection fraction (R(2) = 0.50; P = .001). CONCLUSIONS: The factors found that related to baseline HRQOL and were predictive of the change in HRQOL were primarily clinical and functional in nature. This suggests that those who have greater physical functionality, the confidence to perform physical tasks, and are not limited clinically, may more readily adapt to cardiac rehabilitation and progress more rapidly. Those patients with the poorest exercise capacities at entrance to the program tended to make the greatest gains in HRQOL.