研究表明,家庭心脏康复(HBCR)和中心心脏康复(CBCR)在12个月的短期随访期间在降低死亡率方面表现出可比的功效。然而,关于与HBCR相关的性别和种族特定结局的研究有限。这项研究检查了被称为HBCR的患者的全因死亡率和再入院率,按性别和种族分层。
■这项KaiserPermanenteSouthernCalifornia(KPSC)回顾性队列研究追踪了6,868名从HBCR转诊直至死亡的患者,退伍,或2021年12月31日。有3,835名HBCR毕业生,722名非毕业生,2,311名非入选患者。Cox模型用于估计风险比(HR)和95%置信区间(CI)比较1)HBCR毕业生与未注册,和2)HBCR毕业生与非毕业生,按性别和种族分层。使用Kaplan-Meier曲线分析地层之间的差异结果。
■在涉及HBCR的6,868名患者中,4693(68.3%)为男性,2,175(31.7%)女性,870名(12.7%)亚洲/太平洋岛民,731(10.6%)非洲裔美国人,1,612(23.6%)西班牙裔/拉丁裔,和3646名非西班牙裔白人(53.1%)。在平均2.28年的随访期内,HBCR毕业生,与未参加HBCR的患者相比,全因死亡率和住院风险总体上显著降低.这些结果在按性别和种族分层时仍然很重要。与HBCR非毕业生相比,HBCR毕业生总体上具有显著较低的全因死亡率和住院风险。在同样的比较中,男性和白人患者的死亡风险显着降低;两种性别的再入院风险显着降低,非洲裔美国人,白人患者在HBCR毕业生中,不同性别和种族的全因死亡率或再入院率无显著差异.
■HBCR参与与不同性别和种族的全因死亡率和医院再入院率的降低有关。值得注意的是,我们观察到不同参与水平的好处,这表明即使部分完成HBCR也与风险降低有关。在HBCR毕业生中,我们发现不同性别和种族的结果相似,这表明该计划可以在不同的患者群体中有效。
UNASSIGNED: Studies have shown that both home-based cardiac rehabilitation (HBCR) and center-based cardiac rehabilitation (CBCR) exhibit comparable efficacy in reducing mortality during short-term follow-up periods of up to 12 months. However, research on sex- and race-specific outcomes associated with HBCR is limited. This study examines all-cause mortality and hospital readmission among patients referred to HBCR, with stratification by sex and race.
UNASSIGNED: This Kaiser Permanente Southern California (KPSC) retrospective cohort study followed 6,868 patients from HBCR referral until death, disenrollment, or December 31, 2021. There were 3,835 HBCR graduates, 722 non-graduates, and 2,311 non-enrolled patients. Cox models were used to estimate hazard ratios (HR) and 95 % confidence intervals (CI) comparing 1) HBCR graduates vs. non-enrolled, and 2) HBCR graduates vs. non-graduates, stratified by sex and race. Differential outcomes among strata were analyzed using Kaplan-Meier curves.
UNASSIGNED: Among the 6,868 patients referred to HBCR, 4693 (68.3 %) were male, 2,175 (31.7 %) female, 870 (12.7 %) Asian/Pacific Islander, 731 (10.6 %) African American, 1,612 (23.6 %) Hispanic/Latino, and 3,646 non-Hispanic White (53.1 %). Over a mean follow-up period of 2.28 years, HBCR graduates, compared to patients who did not enroll in HBCR, had overall significantly lower risks of all-cause mortality and hospitalization. These results remained significant with stratification by sex and race. Compared to HBCR non-graduates, HBCR graduates overall had significantly lower risks of all-cause mortality and hospitalization. In the same comparison, mortality risk was significantly reduced for male and White patients; risk of hospital readmission was significantly reduced in both sexes, African American, and White patients. Among HBCR graduates, no significant differences in all-cause mortality or hospital readmission were observed across sexes and races.
UNASSIGNED: HBCR participation is associated with reduction of all-cause mortality and hospital readmission rates across sexes and races. Notably, we observed benefits at varying levels of engagement, which suggests that even partial completion of HBCR is associated with risk reduction. Among HBCR graduates, we found similar outcomes across sexes and races, which suggests that the program can be effective among diverse patient groups.