Effects of acute-phase multidisciplinary rehabilitation on unplanned readmissions aver cardiac surgery

Objectives: The provision of inpatient programs that reduce the incidence of readmission after cardiac surgery remains challenging. Investigators have focused on multidisciplinary cardiac rehabilitation (CR) because it reduces the postoperative readmission rate; however, most previous studies used outpatient models (phase II CR). We retrospectively investigated the effect of comprehensive multidisciplinary interventions in the acute inpatient phase (phase I CR) on unplanned hospital readmission. Methods: In a retrospective cohort study, we compared consecutive patients after cardiac surgery. We divided them into the multidisciplinary CR (multi-CR) group or conventional exercise-based CR (cony-CR) group according to their postoperative intervention during phase I CR. Multi-CR included psychological and educational intervention and individualized counseling in addition to cony-CR. The primary outcome was unplanned readmission rates between the groups. A propensity score-matching analysis was performed to minimize selection biases and the differences in clinical characteristics. Results: In our cohort (n = 341), 56 (183%) patients had unplanned readmission during the follow-up period (median, 419 days). Compared with the cony-CR group, the multi-CR group had a significantly lower unplanned readmission rate (multivariable regression analysis; hazard ratio, 0.520; 95% confidence interval, 0.28-0.95; P = .024). A Kaplan-Meier analysis of our propensity score-matched cohort showed that, compared with the cony-CR group, the multi-CR group had a significantly lower incidence of readmission (stratified log-rank test, P =.041). Conclusions: In phase I, compared to cony-CR alone, multi-CR reduced the incidence of unplanned readmission. Early multidisciplinary CR can reduce hospitalizations and improve long-term prognosis after cardiac surgery.

Automated summary

This retrospective study examined the impact of comprehensive multidisciplinary interventions on unplanned readmission after cardiac surgery. The findings suggest that early multidisciplinary cardiac rehabilitation can significantly reduce unplanned readmission rates and improve long-term prognosis.