Effect of Early Rehabilitation on Physical Function in Patients Undergoing Coronary Artery Bypass Grafting: A Nationwide Inpatient Database Study
It is unclear when to begin rehabilitation after coronary artery bypass grafting (CABG) in the intensive care unit (ICU). Using the Japanese Diagnosis Procedure Combination inpatient database from 2010 to 2018, we identified adult patients who underwent a CABG and who were admitted to the ICU for ≥3...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-02-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/10/4/618 |
| _version_ | 1797413796408459264 |
|---|---|
| author | Hiroyuki Ohbe Kensuke Nakamura Kazuaki Uda Hiroki Matsui Hideo Yasunaga |
| author_facet | Hiroyuki Ohbe Kensuke Nakamura Kazuaki Uda Hiroki Matsui Hideo Yasunaga |
| author_sort | Hiroyuki Ohbe |
| collection | DOAJ |
| description | It is unclear when to begin rehabilitation after coronary artery bypass grafting (CABG) in the intensive care unit (ICU). Using the Japanese Diagnosis Procedure Combination inpatient database from 2010 to 2018, we identified adult patients who underwent a CABG and who were admitted to the ICU for ≥3 consecutive days from the date of their CABG. Patients who started any rehabilitation program prescribed by physicians or therapists within 3 days of CABG were defined as the early rehabilitation group, and the remaining patients were defined as the usual care group. We identified 30,568 eligible patients, with 13,150 (43%) patients in the early rehabilitation group. An inverse probability of treatment weighting analyses showed that the Barthel Index score at discharge in the early rehabilitation group was significantly higher than that in the usual care group (difference: 3.2; 95% confidence interval: 1.5–4.8). The early rehabilitation group had significantly lower in-hospital mortality, total hospitalization costs, length of ICU stay, and hospital stay vs. the usual care group. Our results suggested that early rehabilitation by physicians or therapists beginning within 3 days of CABG was safe, as suggested by the low mortality and improved physical function in patients who underwent CABG. |
| first_indexed | 2024-03-09T05:22:55Z |
| format | Article |
| id | doaj.art-2d2bdee561f3429c9ca70583d9a502d0 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T05:22:55Z |
| publishDate | 2021-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-2d2bdee561f3429c9ca70583d9a502d02023-12-03T12:38:38ZengMDPI AGJournal of Clinical Medicine2077-03832021-02-0110461810.3390/jcm10040618Effect of Early Rehabilitation on Physical Function in Patients Undergoing Coronary Artery Bypass Grafting: A Nationwide Inpatient Database StudyHiroyuki Ohbe0Kensuke Nakamura1Kazuaki Uda2Hiroki Matsui3Hideo Yasunaga4Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1130033, JapanDepartment of Emergency and Critical Care Medicine, Hitachi General Hospital, 2-1-1, Jonantyo, Hitachi, Ibaraki 3170077, JapanDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1130033, JapanDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1130033, JapanDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1130033, JapanIt is unclear when to begin rehabilitation after coronary artery bypass grafting (CABG) in the intensive care unit (ICU). Using the Japanese Diagnosis Procedure Combination inpatient database from 2010 to 2018, we identified adult patients who underwent a CABG and who were admitted to the ICU for ≥3 consecutive days from the date of their CABG. Patients who started any rehabilitation program prescribed by physicians or therapists within 3 days of CABG were defined as the early rehabilitation group, and the remaining patients were defined as the usual care group. We identified 30,568 eligible patients, with 13,150 (43%) patients in the early rehabilitation group. An inverse probability of treatment weighting analyses showed that the Barthel Index score at discharge in the early rehabilitation group was significantly higher than that in the usual care group (difference: 3.2; 95% confidence interval: 1.5–4.8). The early rehabilitation group had significantly lower in-hospital mortality, total hospitalization costs, length of ICU stay, and hospital stay vs. the usual care group. Our results suggested that early rehabilitation by physicians or therapists beginning within 3 days of CABG was safe, as suggested by the low mortality and improved physical function in patients who underwent CABG.https://www.mdpi.com/2077-0383/10/4/618rehabilitationphysical impairmentscoronary artery bypass graftingintensive care unitpost-intensive care syndromeobservational study |
| spellingShingle | Hiroyuki Ohbe Kensuke Nakamura Kazuaki Uda Hiroki Matsui Hideo Yasunaga Effect of Early Rehabilitation on Physical Function in Patients Undergoing Coronary Artery Bypass Grafting: A Nationwide Inpatient Database Study Journal of Clinical Medicine rehabilitation physical impairments coronary artery bypass grafting intensive care unit post-intensive care syndrome observational study |
| title | Effect of Early Rehabilitation on Physical Function in Patients Undergoing Coronary Artery Bypass Grafting: A Nationwide Inpatient Database Study |
| title_full | Effect of Early Rehabilitation on Physical Function in Patients Undergoing Coronary Artery Bypass Grafting: A Nationwide Inpatient Database Study |
| title_fullStr | Effect of Early Rehabilitation on Physical Function in Patients Undergoing Coronary Artery Bypass Grafting: A Nationwide Inpatient Database Study |
| title_full_unstemmed | Effect of Early Rehabilitation on Physical Function in Patients Undergoing Coronary Artery Bypass Grafting: A Nationwide Inpatient Database Study |
| title_short | Effect of Early Rehabilitation on Physical Function in Patients Undergoing Coronary Artery Bypass Grafting: A Nationwide Inpatient Database Study |
| title_sort | effect of early rehabilitation on physical function in patients undergoing coronary artery bypass grafting a nationwide inpatient database study |
| topic | rehabilitation physical impairments coronary artery bypass grafting intensive care unit post-intensive care syndrome observational study |
| url | https://www.mdpi.com/2077-0383/10/4/618 |
| work_keys_str_mv | AT hiroyukiohbe effectofearlyrehabilitationonphysicalfunctioninpatientsundergoingcoronaryarterybypassgraftinganationwideinpatientdatabasestudy AT kensukenakamura effectofearlyrehabilitationonphysicalfunctioninpatientsundergoingcoronaryarterybypassgraftinganationwideinpatientdatabasestudy AT kazuakiuda effectofearlyrehabilitationonphysicalfunctioninpatientsundergoingcoronaryarterybypassgraftinganationwideinpatientdatabasestudy AT hirokimatsui effectofearlyrehabilitationonphysicalfunctioninpatientsundergoingcoronaryarterybypassgraftinganationwideinpatientdatabasestudy AT hideoyasunaga effectofearlyrehabilitationonphysicalfunctioninpatientsundergoingcoronaryarterybypassgraftinganationwideinpatientdatabasestudy |