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ICF framework in cardiac rehabilitation: a real-life implementation in post-cardiac surgery and chronic heart failure patients.
- Source :
-
European journal of physical and rehabilitation medicine [Eur J Phys Rehabil Med] 2023 Oct; Vol. 59 (5), pp. 605-614. Date of Electronic Publication: 2023 Jun 28. - Publication Year :
- 2023
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Abstract
- Background: The International Classification of Functioning, Disability, and Health (ICF) is growing in importance in cardiac rehabilitation (CR) as the number of elderly comorbid patients increases.<br />Aim: To classify through the ICF framework a group of post-cardiac surgery (CS) and chronic heart failure (CHF) patients undergoing rehabilitation. Then, to compare the two groups and identify possible factors at admission that could affect ICF evaluations at discharge.<br />Design: Observational retrospective real-life study.<br />Setting: Two inpatient CR units.<br />Population: Consecutive CS and CHF patients admitted for CR (January-December 2019).<br />Methods: Clinical, anthropometric data and functional status at admission and discharge were extracted from patient health records. A set of 26 ICF codes regarding body functions (b) and activities (d) was analyzed to identify: 1) the qualifiers attributed (from 0=no impairment to 4=severe impairment) for each code, 2) the percent distribution of qualifiers (0/1/2/3/4) attributed per patient. We then evaluated changes in both (1) and (2 - defined as ICF Delta%) from admission to discharge.<br />Results: All patients (55% males; mean age 73±12 years) showed an improvement post-rehabilitation in the ICF qualifiers attributed (P<0.0001 for all codes). CS patients (N.=150) were less functionally impaired at admission than CHF (N.=194) (P<0.05 for all codes), and at discharge showed greater Delta% in the qualifiers 0/1/2 attributed than CHF (P<0.0001 for b codes; P<0.05 for d codes). Delta% for qualifiers 3 and 4 was similar in the two groups. No impairment at admission (qualifier 0), CS group, and presence/complexity of comorbidities were identified as possible covariates influencing ICF qualifiers at discharge, impacting the rate of both no/mild impairment (ICF% aggregate 0+1 - adjusted R <superscript>2</superscript> =0.627; P<0.0001) and moderate impairment (ICF% qualifier 2 - adjusted R <superscript>2</superscript> =0.507; P<0.0001).<br />Conclusions: CHF patients showed a worse ICF picture at admission and less improvement at discharge than CS. The presence and complexity of comorbidities negatively influenced the ICF classification at discharge, especially in CHF patients.<br />Clinical Rehabilitation Impact: This study shows the utility of ICF classification in CR as a means for describing, measuring, and comparing patient functioning across the care continuum.
Details
- Language :
- English
- ISSN :
- 1973-9095
- Volume :
- 59
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- European journal of physical and rehabilitation medicine
- Publication Type :
- Academic Journal
- Accession number :
- 37377129
- Full Text :
- https://doi.org/10.23736/S1973-9087.23.07666-9