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Rehabilitation Practice and Science

Translated Title

急性ST節段升高之心肌梗塞患者第一期心臟復健

Abstract

Background and Purpose: Phase I cardiac rehabilitation (CR) programs have been shown to be effective and beneficial for patients with acute myocardial infarction. However, only few studies have evaluated the determinants of treatment frequency in phase I CR. The aim of this study was to investigate the current administration of phase I CR for patients who have acute ST-elevation myocardial infarction (STEMI) and have undergone percutaneous coronary intervention (PCI) in a medical center in Taiwan.Methods: We retrospectively reviewarticleed the medical records of 30 patients with STEMI who were admitted to the coronary care unit (CCU) between December 2009 and March 2010 in order to examine details about the consultation process and these patient's participation in phase I and phase II CR.Results: Twenty-eight patients (93.3%) with STEMI participated in phase I CR after PCI. The mean duration of hospital stay was 5.2 days. The mean durations from admission to consultation, for completing consultation, and for initiating therapy after exercise prescription were 20.7 hours, 7.1 hours, and 20.6 hours, respectively. The mean total treatment time was 2 times (range: 0-5 times), and it correlated with the patient's duration of stay in the general ward and the total duration of hospitalization (R = 0.559 and 0.461, respectively). The treatment frequency was 0.4 times/day inclusive of holidays and increased to 0.52 times/day after the exclusion of holidays. The prolonged waiting period for the first CR treatment negatively correlated with the total treatment times and treatment frequency in the cardiac intensive care unit and with the total duration of hospitalization. None of the patients in our study presented with cardiac complications during phase I CR. Twenty-seven (90%) patients continued regular follow-ups at clinics of cardiology; however, only 2 patients (6.7%) entered phase II CR.Conclusions: Most STEMI patients who underwent primary PCI participated in the phase I CR program. The frequency of attending phase I CR program correlated with the duration of hospitalization but not with the Killip classification or left ventricular ejection fraction. The participation rate in phase II CR was very low. To improve treatment frequency, facilitation of the consultation process and provision of treatment even on holidays must be considered. It is important that STEMI patients and cardiologists are made aware of the benefits of outpatient CR in order to increase participation in phase II CR programs. ( Tw J Phys Med Rehabil 2012; 40(1): 25 - 33 )

Language

Traditional Chinese

First Page

25

Last Page

33

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