title: Cardiac rehabilitation in chronic heart failure: data from the Italian SurveY on carDiac rEhabilitation (ISYDE-2008).
abstract: BACKGROUND
  Using data from the Italian SurveY on carDiac rEhabilitation (ISYDE-2008), this study provides insight into the level of implementation of cardiac rehabilitation in patients with chronic heart failure (CHF).
  
  
  METHODS
  Data from 165 Italian cardiac rehabilitation units were collected online from 28 January to 10 February 2008.
  
  
  RESULTS
  The study cohort consisted of 2281 patients (66.9 ± 11.8 years): 285 (71.3 ± 12.2 years, 66% male) CHF patients and 1996 (66.3 ± 11.6 years, 74% male) non-CHF patients. Compared with non-CHF, CHF patients were older, showed more comorbidity, had lower left ventricular (LV) ejection fraction and reduced access to functional evaluation, underwent more complications during cardiac rehabilitation, and had longer length of in-hospital stay. CHF patients were also more likely to be transferred to ICU (9 versus 3%, P < 0.0001), and less likely to be discharged home (85 versus 92%, respectively, P < 0.0001). Also, discharge prescriptions were significantly different from those of non-CHF patients. Finally, CHF patients had higher mortality during cardiac rehabilitation (1.7 versus 0.5%, P = 0.01). After adjusting for age, ejection fraction, comorbidity, previous interventions and complications during cardiac rehabilitation, multivariate logistic analysis showed that not performing any of the physical performance tests [odds ratio (OR) = 7.0, 95% confidence interval (CI), 1.9-25.8, P = 0.003], acute respiratory failure (OR = 2.3, 95% CI, 1.3-4.1, P = 0.002), acute kidney insufficiency or worsening of chronic kidney disease (OR = 2.9, 95% CI, 1.5-5.6, P = 0.001) and worsening of cognitive impairment (OR = 3.7, 95% CI, 2.0-6.7, P < 0.001) were significant predictors of death in CHF patients.
  
  
  CONCLUSIONS
  The ISYDE-2008 survey provided a detailed snapshot of cardiac rehabilitation in CHF patients, and confirmed the complexity and the more severe clinical course of these patients during cardiac rehabilitation.
authors: aDepartment of Clinical Medicine, Cardiovascular and Immunological Sciences, Cardiac Rehabilitation Unit, University of Naples 'Federico II', Naples, Italy bDepartment of Critical Care Medicine and Surgery, Cardiac Rehabilitation Unit, University of Florence and Azienda Ospedaliero-Universitaria Careggi, Florence (FI), Italy cDivision of Cardiac Rehabilitation, Fondazione Europea di Ricerca Biomedica, Cernusco S/N (MI), Italy dClinica 'Le Terrazze', Cunardo (VA), Italy eDepartment of Cardiology, Cardiac Rehabilitation Unit, La Colletta Hospital, Arenzano (GE), Italy fAzienda Ospedaliera S. Anna e S. Sebastiano di Caserta, Caserta (CE), Italy.
authors: Francesco
authors: F
authors: Giallauria
authors: Francesco
authors: F
authors: Fattirolli
authors: Roberto
authors: R
authors: Tramarin
authors: Marco
authors: M
authors: Ambrosetti
authors: Raffaele
authors: R
authors: Griffo
authors: Carmine
authors: C
authors: Riccio
authors: Carlo
authors: C
authors: Vigorito
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002908:Chronic Disease; D015897:Comorbidity; D005260:Female; D019538:Health Care Surveys; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010351:Patient Discharge; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left