Associazione Nazionale Medici Cardiologi Ospedalieri



Frailty influence on physical and psychological outcomes in post-cardiac surgery patients cardiac rehabilitation, a single center study.

Villani Giovanni Quinto Ponte Dell’Olio (Piacenza) – Opedale Riabilitativo San Giacomo | Aschieri Daniela Piacenza (Piacenza) – Uoc Cardiologia | Bolognesi Giulia Piacenza (Piacenza) – Uoc Cardiologia | Ferraro Stefano Piacenza (Piacenza) – Uoc Cardiologia | Pisati Maria Sole Piacenza (Piacenza) – Uoc Cardiologia | Rusticali Guido Piacenza (Piacenza) – Uoc Cardiologia | Rosi Alessandro Ponte Dell’Olio (Piacenza) – Ospedale Riabilitativo San Giacomo

Cardiac rehabilitation (CR) is a clinically and cost-effective intervention in post-cardiac surgery patients (PCSp). However the influence of patients frailty on clinical and psychological outcomes in these patients are not well-known.

The aim of our work was to evaluate the effectiveness of a personalized rehabilitative therapy in PCSp divided using the Cumulative Illness Rating Scale (CIRS) in group A (393 low-frail pts, CIRS <3, 230 M,  65±3 yrs) and in a Group B (540 frail pts, CIRS >4, 379 M, 67±10) ) evaluating pre and post-treatment the degree of autonomy recovery (Six-minute walking test SMWT, Barthel Index, BI) and the psychological behaviour  (State-Trait Anxiety Inventory STAI-X1, Depression Questionaire QD-R). 

At admission the comparison between Group A vs B has show:

a  greater loss autonomy  in frail patients  (BI scale A 51.7±1 vs B 28.7±14, p 0.005; SMWT A 245±25 m vs B 155±18 m, p 0.005)
a greater impairment in psychological characteristics in frail patients (STAI-X1 A 18±9 vs B 20±4 p 0.028, QD/R A 3.6±2 vs B4.4±3 p0.001)

At discharge after a similar period  of rehabilitation (A 24.7±11.8 days vs B 25.6±10 days, p ns) we observed:

a more evident improvement of degree of autonomy recovery in low-frai group ((BI scale A 77.7±18 vs B 67.7±19, p 0.001; SMWT A 485±18 m vs B 341±25m, p 0.001)
a similar improvement in anxiety and depression characteristic in both groups (STAI-X1 A 17.8±2 vs B 17.4±4 p ns, QD/R A 3.1±2 vs B 3.4±2 p ns)

Conclusions: In our experience the frailty status does not affect the cardiac rehabilitation in post-cardiac surgery patients in term of ensuring adequate functional recovery (although reduced compared to low-frail patients) but with similar improvement in psychological behaviours.