title: Patient mortality in the 12 years following enrolment into a pre-surgical cardiac rehabilitation programme.
abstract: OBJECTIVE
  This study examined whether involvement in a pre-surgical cardiac rehabilitation programme conferred a long-term survival benefit.
  
  
  METHODS
  Patients randomly allocated to a pre-surgical cardiac rehabilitation programme intervention or a control group were tracked through national databases at a point approximately 12 years later, and all causes of mortality were identified from death records. Kaplan-Meier survival analyses based on involvement in a cardiac rehabilitation programme and known pre-surgical risk factors were carried out.
  
  
  METHODS
  Two health boards in the west of Scotland, referring to a single cardiothoracic tertiary centre.
  
  
  METHODS
  Patients admitted to the waiting list for coronary artery bypass surgery.
  
  
  METHODS
  Patients were randomly allocated to a control group ('usual' care) or an intervention group (nurse-led cardiac rehabilitation) in the pre-operative phase. They were followed up at 12 years post surgery.
  
  
  METHODS
  The only outcome measure used for analysis was survival. Measures of anxiety and depression, and physiological and lifestyle risk factors were included as independent variables in analysis of death.
  
  
  RESULTS
  The initial study included 110 patients--none were lost to follow-up. Relative risk of death associated with inclusion in the cardiac rehabilitation programme was 0.814; risk of death increased with increasing pre-surgical depression (RR 1.07) and anxiety (RR 1.09).
  
  
  CONCLUSIONS
  Undertaking pre-surgical cardiac rehabilitation confers a long-term survival advantage over patients not offered this service. Increased anxiety and depression in the pre-surgical phase are additional risk factors for increased mortality.
authors.affiliation: School of Health Glasgow Caledonian University, Glasgow, UK. andrew.rideout@gcu.ac.uk
authors.forename: Andrew
authors.initials: A
authors.lastname: Rideout
authors.forename: Grace
authors.initials: G
authors.lastname: Lindsay
authors.forename: Jon
authors.initials: J
authors.lastname: Godwin
mesh_terms: D001008:Anxiety Disorders / Q000453:epidemiology*; D001026:Coronary Artery Bypass / Q000401:mortality* / Q000523:psychology / Q000534:rehabilitation*; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D017063:Outcome Assessment, Health Care; D011300:Preoperative Care / Q000379:methods*; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology