Association of early cardiac rehabilitation on mortality in patients with dilated cardiomyopathy using national inpatient database

TL;DR

This study finds that starting cardiac rehabilitation within three days of hospital admission lowers 90-day mortality in patients with dilated cardiomyopathy.

Contribution

The novel contribution is evidence that early cardiac rehabilitation reduces mortality in dilated cardiomyopathy patients using a large national database.

Findings

Early cardiac rehabilitation was associated with a 30% lower 90-day mortality risk in DCM patients.

Patients receiving early CR had higher activities of daily living scores at discharge.

There was no significant difference in hospital length of stay between the groups.

Abstract

Dilated cardiomyopathy (DCM) is a complex disease characterized by cardiomyopathic hypokinesis and left ventricular interior hypertrophy. Cardiac rehabilitation (CR) is an established treatment for some cardiovascular diseases; however, the outcomes of early CR for patients with DCM remain underexplored. This study aimed to investigate the association between early CR and 90-day mortality in patients with DCM and symptomatic heart failure, using a national inpatient database in Japan from July 1, 2010, to March 31, 2020. We applied multiple imputation to the missing data and propensity score matching analysis. Early CR was defined as that initiated within 3 days of admission. The study included 30,296 eligible patients, including those with early CR (n = 3,130) and delayed or no CR (n = 27,166). The early CR group showed significantly lower 90-day mortality compared to the delayed or no CR group (odds ratio, 0.70, 95% confidence interval, 0.53–0.93; P = 0.01). Compared to the delayed or no CR group, the early CR group exhibited a higher activities of daily living score at discharge, but there was no significant difference in length of stay between the groups.

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