[New Eastern Westfalian Postoperative Therapeutic Concept (NOPT). A telemedically guided study for ambulatory rehabilitation of patients after cardiac surgery].
OBJECTIVE
In-hospital rehabilitation can improve recovery of patients after surgery, but also contributes to the high costs of the German health system. Therefore, the possibility of a telemedically monitored rehabilitation at home as an alternative to an in-hospital rehabilitation was evaluated in a pilot study.


METHODS
In an open trial, 100 patients performed an ambulatory rehabilitation after heart surgery under coverage of telemedical monitoring for 3 months. 70 patients performed a regular conventional in-hospital rehabilitation for 3 weeks. Physical performance, quality of life (questionnaire), complications, and costs were assessed and compared between the two groups.


RESULTS
6 and also 12 months after surgery, maximal physical performance was significantly increased by 46-54 W in both study groups compared to their baseline value. Moreover, physical and psychological quality of life had increased in both study groups compared to baseline values. However, only in the ambulatory group all items had increased with statistical significance. Fewer insults of angina pectoris were reported during follow-up in the ambulatory group compared to the in-hospital group (p < 0.01). Total costs of the rehabilitation were 59% lower in the ambulatory group compared to the in-hospital group.


CONCLUSIONS
An ambulatory rehabilitation improves physical performance, quality of life, and is safe and cheap. The data of this study indicate that rehabilitation at home can be established instead of an in-hospital rehabilitation for patients after heart surgery.
Körtke
Heinrich
H
Klinik für Thorax- und Kardiovaskularchirurgie, Herzzentrum Nordrhein-Westfalen, Bad Oeynhausen. hkoertke@hdz-nrw.de
Zittermann
Armin
A
El-Arousy
Mahmoud
M
Zimmermann
Elke
E
Wienecke
Elmar
E
Körfer
Reiner
R
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics; D006348:Cardiac Surgical Procedures / Q000191:economics / Q000534:rehabilitation*; D003362:Cost-Benefit Analysis; D019091:Critical Pathways / Q000191:economics; D015716:Electrocardiography, Ambulatory / Q000191:economics; D005080:Exercise Test / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000191:economics / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics; D010343:Patient Admission / Q000191:economics; D010865:Pilot Projects; D017216:Telemedicine / Q000191:economics