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Drop-out predictors in cardiac rehabilitation programmes and the impact of sex differences among coronary heart disease patients in an Iranian sample: a cohort study

Isfahan Cardiovascular Research Center, sarrafzadegan{at}med.mui.ac.ir

Katayoun Rabiei

Rehabilitation Department, Isfahan Cardiovascular Research Center

Shahin Shirani

Isfahan Cardiovascular Research Center, WHO Collaborating Center, Isfahan University of Medical Sciences

Ali Kabir

Health Researchers R&D Institute, Tehran

Noushin Mohammadifard

Nutrition Department, Isfahan Cardiovascular Research Center

Hamidreza Roohafza

Mental Health Department, Isfahan Cardiovascular Research Center, WHO Collaborating Center, Isfahan University of Medical Sciences, Iran

Objective : To determine whether patients who subsequently drop out of a structured cardiac rehabilitation programme could be prospectively distinguished from those who remain in the programme based upon their initial baseline characteristics.

Design : A cohort study.

Setting : A referral rehabilitation department in a cardiovascular research and training institute.

Subjects : One thousand one hundred and fifteen coronary heart disease patients including patients with ischaemic heart disease, and those undergoing bypass surgery or percutaneous coronary interventions.

Interventions : Demographic characteristics, coronary heart disease risk factors, ejection fraction, functional capacity and laboratory tests were considered at baseline.

Main measures : Patients who completed all 24 sessions of the cardiac rehabilitation programme were compared with drop-out cases who did not.

Results : Four hundred and ninety-nine patients (44.8%) completed the whole cardiac rehabilitation programme. Women (adjusted odds ratio (AOR) 1.817, P < 0.001), older patients (AOR 1.015, P = 0.047), patients with lower risk of coronary heart disease (AOR 1.573, P = 0.008) or lower body mass index (BMI) (AOR 0.945, P = 0.001) and higher waist-to-hip ratio (AOR 12.871, P = 0.009) and those who were non-smokers (AOR 1.779, P = 0.001) were significantly more likely to complete cardiac rehabilitation.

Conclusions : Developing interventions to address special needs of young, obese, smoker male patients who have a lower waist-to-hip ratio and higher clinical risk may be important, especially in attempts to retain this high-risk group in cardiac rehabilitation therapy.

Clinical Rehabilitation, Vol. 21, No. 4, 362-372 (2007)
DOI: 10.1177/0269215507072193


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