Early rehabilitation after acute myocardial infarction: A nationwide inpatient database study.

Abstract

BACKGROUND\nThe effects and safety of early rehabilitation in intensive care units (ICU) remain unclear for patients after acute myocardial infarction (AMI).\n\n\nMETHODS\nUsing Japanese Diagnosis Procedure Combination inpatient data between July 2010 and March 2018, we identified 31,603 adult patients with AMI who underwent percutaneous coronary intervention on the day of admission and who were admitted to the ICU for more than three consecutive days. Patients who started a rehabilitation program within three days of ICU admission were included in the early rehabilitation group, while others were included in the usual care group. The primary outcome was activities of daily living (ADL) at discharge, as measured using the Barthel Index score. We conducted inverse probability of treatment weighting analyses.\n\n\nRESULTS\nThe data of 31,603 patients were examined, 5,147 of whom were assigned to the early rehabilitation group. In the weighted cohort, the Barthel Index score at discharge was not significantly different between the two groups. The early rehabilitation group had a significantly shorter hospital stay, shorter ICU stay, and lower total hospitalization costs.\n\n\nCONCLUSIONS\nNo correlations were observed between early rehabilitation and ADL at discharge. However, the present results suggest that early rehabilitation is safe and associated with lower hospital costs and shorter hospital stays after AMI.