Academic Journal
Door-to-Cardiac Rehabilitation Time and Clinical Outcomes in Patients Hospitalized for Acute Heart Failure: A Nationwide Japanese Registry.
| Τίτλος: | Door-to-Cardiac Rehabilitation Time and Clinical Outcomes in Patients Hospitalized for Acute Heart Failure: A Nationwide Japanese Registry. |
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| Συγγραφείς: | Katano S; Division of Rehabilitation Sapporo Medical University Hospital Sapporo Japan.; Department of Rehabilitation Sapporo Medical University School of Medicine Sapporo Japan., Yano T; Division of Cardiovascular-Kidney-Metabolic Medicine, Department of Internal Medicine Sapporo Medical University School of Medicine Sapporo Japan., Kono Y; Department of Rehabilitation Fujita Health University Hospital Toyoake Japan., Sawamura A; Department of Cardiology Ichinomiya Municipal Hospital Ichinomiya Japan., Kanaoka K; Department of Medical and Health Information Management National Cerebral and Cardiovascular Center Suita Japan., Motokawa T; Department of Cardiology Nagasaki University Hospital Nagasaki Japan., Miyamoto Y; Department of Medical and Health Information Management National Cerebral and Cardiovascular Center Suita Japan., Ohya Y; Department of Cardiology University of the Ryukyus Okinawa Japan., Miura SI; Department of Cardiology Fukuoka University School of Medicine Fukuoka Japan., Fukuma N; Department of Cardiovascular Medicine Nippon Medical School Bunkyo-ku Japan., Makita S; Department of Rehabilitation Kawaguchi Cupola Rehabilitation Hospital Kawaguchi Japan., Fukumoto Y; Division of Cardiovascular Medicine, Department of Medicine Kurume University School of Medicine Kurume Japan., Izawa H; Department of Cardiology Fujita Health University Toyoake Japan. |
| Πηγή: | Journal of the American Heart Association [J Am Heart Assoc] 2026 Oct 06; Vol. 15 (19), pp. e051493. Date of Electronic Publication: 2026 Sep 24. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford : Wiley-Blackwell |
| Ιατρικοί όροι (MeSH): | Heart Failure*/rehabilitation , Heart Failure*/mortality , Heart Failure*/physiopathology , Heart Failure*/diagnosis , Cardiac Rehabilitation*/methods , Time-to-Treatment*, Japan/epidemiology ; Humans ; Female ; Registries ; Male ; Aged ; Hospital Mortality ; Time Factors ; Aged, 80 and over ; Acute Disease ; Treatment Outcome ; Hospitalization ; Middle Aged ; Risk Factors ; East Asian People |
| Περίληψη: | Background: Cardiac rehabilitation (CR) improves outcomes in heart failure, but optimal initiation timing during acute hospitalization remains undefined. We characterized the dose-response association between door-to-cardiac rehabilitation time and in-hospital outcomes, describing how this pattern appeared to differ between death and functional measures. Methods: Using the Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure database, we identified 564 830 patients hospitalized for acute heart failure (2012-2023), categorized into non-CR (n=275 454) and CR groups by door-to-cardiac rehabilitation quartiles: quartile 1 (≤1 day), quartile 2 (2-3 days), quartile 3 (4-5 days), and quartile 4 (≥6 days). Generalized propensity score-based weighting adjusted for 32 confounders. Restricted cubic splines evaluated dose-response patterns among CR recipients. The primary outcome was in-hospital death; secondary outcomes were Barthel Index at discharge and Barthel Index improvement. Results: All door-to-cardiac rehabilitation quartiles showed lower in-hospital death versus non-CR (adjusted odds ratios, 0.39-0.49; all P<0.001). Barthel Index at discharge was higher in quartile 1 to quartile 3 (mean difference, +3.2 to +3.8 points), with a smaller difference in quartile 4. Spline analysis revealed nonlinear associations: The mortality nadir was observed at 6.1 days, whereas functional measures showed the most favorable associations at 3.3 days. Sensitivity analyses addressing immortal time bias yielded consistent mortality results. Conclusions: CR was associated with a lower in-hospital mortality rate across all timing quartiles. The association pattern appeared to differ by outcome domain: Functional measures showed more favorable associations with earlier initiation (within 2-3 days), whereas a lower mortality rate was observed across a broader window. These findings warrant prospective evaluation. |
| Contributed Indexing: | Keywords: activities of daily living; cardiac rehabilitation; heart failure; hospital mortality; time‐to‐treatment |
| Entry Date(s): | Date Created: 20260925 Date Completed: 20261008 Latest Revision: 20261008 |
| Update Code: | 20261008 |
| DOI: | 10.1161/JAHA.126.051493 |
| PMID: | 42786652 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 2047-9980 |
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| DOI: | 10.1161/JAHA.126.051493 |