The Effectiveness of Early Rehabilitation after Cardiac Surgery / 日本心臓血管外科学会雑誌

ABSTRACT

The purpose of this study was to evaluate the efficacy of early rehabilitation starting on the day after cardiac surgery. In the early rehabilitation program, introduced from November 2006, we adopted an original video program about hospitalization and daily multi-specialist conference in the ICU. We divided 179 patients who underwent elective cardiac operation from June 2004 to September 2007 (mean age 65.4 years old, 51 women, 91 CABG, 53 valve procedures and 35 other procedure) into group A (the initial rehabilitation group <i>n</i>=73) and group B (the early rehabilitation group <i>n</i>=106). There were no significant differences in patient profile (age, gender, operation time etc.) between the two groups. The mean postoperative day of starting cardiac rehabilitation was 4.3+/-1.6 days in group A and 1.5+/-1.0 days in group B (<i>p</i><0.01). The mean achievement period of all walking distances in group B was significantly shorter than in group A as follows, 50 m group A 5.4+/-2.2 vs. group B 3.1+/-1.5 days (<i>p</i><0.01), 100 m group A 6.9+/-3.1 vs. group B 4.9+/-2.2 days (<i>p</i><0.01), 200 m group A 8.5+/-3.9 vs. group B 6.5+/-2.5 days (<i>p</i><0.01), 300 m group A 10.2+/-3.9 vs. group B 8.1+/-2.9 days (<i>p</i><0.01), 500 m group A 14.5+/-6.1 vs. group B 11.9+/-3.8 days (<i>p</i><0.05). Approximately 90 per cent of patients in group B could walk by themselves on leaving the ICU. There were no major complications throughout rehabilitation. The mean hospital stay was 31.0+/-11.2 days for group A and 25.9+/-7.4 days for the group B, with a statistically significant difference (<i>p</i>=0.03). In a questionnaire survey at discharge, 91.0 per cent of patients in group B answered that early rehabilitation was most gratifying. In conclusion, early rehabilitation after cardiac surgery is effective for early recovery of ADL and leads to shorter hospital stay. We think both preoperative education and daily conferences are indispensable for safe and effective early rehabilitation programs.