title: Outcome quality of in-patient cardiac rehabilitation in elderly patients--identification of relevant parameters.
abstract: BACKGROUND
  Outcome quality management requires the consecutive registration of defined variables. The aim was to identify relevant parameters in order to objectively assess the in-patient rehabilitation outcome.
  
  
  METHODS
  From February 2009 to June 2010 1253 patients (70.9 ± 7.0 years, 78.1% men) at 12 rehabilitation clinics were enrolled. Items concerning sociodemographic data, the impairment group (surgery, conservative/interventional treatment), cardiovascular risk factors, structural and functional parameters and subjective health were tested in respect of their measurability, sensitivity to change and their propensity to be influenced by rehabilitation.
  
  
  RESULTS
  The majority of patients (61.1%) were referred for rehabilitation after cardiac surgery, 38.9% after conservative or interventional treatment for an acute coronary syndrome. Functionally relevant comorbidities were seen in 49.2% (diabetes mellitus, stroke, peripheral artery disease, chronic obstructive lung disease). In three key areas 13 parameters were identified as being sensitive to change and subject to modification by rehabilitation: cardiovascular risk factors (blood pressure, low-density lipoprotein cholesterol, triglycerides), exercise capacity (resting heart rate, maximal exercise capacity, maximal walking distance, heart failure, angina pectoris) and subjective health (IRES-24 (indicators of rehabilitation status): pain, somatic health, psychological well-being and depression as well as anxiety on the Hospital Anxiety and Depression Scale).
  
  
  CONCLUSIONS
  The outcome of in-patient rehabilitation in elderly patients can be comprehensively assessed by the identification of appropriate key areas, that is, cardiovascular risk factors, exercise capacity and subjective health. This may well serve as a benchmark for internal and external quality management.
authors.affiliation: Department of Clinical Pharmacology and Toxicology, Charité (CBF) Berlin, Germany.
authors.forename: Annett
authors.initials: A
authors.lastname: Salzwedel
authors.forename: Manfred
authors.initials: M
authors.lastname: Nosper
authors.forename: Bernd
authors.initials: B
authors.lastname: Röhrig
authors.forename: Sigrid
authors.initials: S
authors.lastname: Linck-Eleftheriadis
authors.forename: Gert
authors.initials: G
authors.lastname: Strandt
authors.forename: Heinz
authors.initials: H
authors.lastname: Völler
mesh_terms: D000367:Age Factors; D000368:Aged; D016507:Cardiology Service, Hospital / Q000592:standards*; D015897:Comorbidity; D017079:Exercise Tolerance; D005260:Female; D015577:Geriatric Assessment; D005858:Germany; D006331:Heart Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D007297:Inpatients; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000592:standards*; D010809:Physical Fitness; D019984:Quality Indicators, Health Care / Q000592:standards*; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome