Authors (including presenting author) :
Cheung HW, Ho MS, Tsang KM, Leung ML
Affiliation :
Department of Medicine & Therapeutics, Prince of Wales Hospital
Introduction :
Cardiac rehabilitation has showed its effectiveness in preventing further coronary attacks and reducing unplanned readmission. Patients with acute coronary syndrome (ACS) admitted to Coronary Care Unit in one local hospital received Phase 1 cardiac rehabilitation (CRP1) and arranged 7- consecutive-week follow ups in Cardiology Nurse Clinic to continue Phase 2 cardiac rehabilitation (CRP2) upon discharge. Many CRP1 patients did not attend the Cardiology Nurse Clinic for CRP2 regardless of its benefits after going home. 262 patients received CRP1 from January 2017 to September 2018 but only 92 of them (35%) attended Cardiology Nurse Clinic for CRP2. An evaluation was done to identify the clinical parameters and unplanned readmissions between those 2 groups.
Objectives :
To evaluate the effectiveness of Cardiology Nurse Clinic in controlling cholesterols, sugar and unplanned readmission during the 1st 3-month post discharge in comparison with those patients who received CRP1 only.
Methodology :
Convenient sampling method was used to include CRP1 and CRP2 patients. Since there were far more CRP1 patients thus CRP1 group included ACS patients who completed CRP1 from October 2017 to September 2018 and CRP2 group included ACS patients who attended Cardiology Nurse Clinic from January 2017 to September 2018. Patients’ clinical parameters in respect to cholesterols (Total, LDL and HDL), sugar and unplanned readmissions within the first 3 months after going home were reviewed and analyzed.
Result & Outcome :
183 (CRP1 = 91; CRP2 = 92) patients’ clinical parameters and readmissions were reviewed. With similar background information in respect to age, sex, ejection fraction, cholesterols and sugar, the 2 groups showed no significant difference in the 3-month post discharge blood tests for cholesterol and sugar levels. CRP2 had slight better HDL (1.3 vs 1.2 mmol/l) and lower LDL (1.4 vs 1.5 mmol/l) as compared to CRP1 where p > 0.05. CRP1 groups had significant higher 3-month unplanned readmissions (19 vs 9 where p < 0.05) than CRP2. CRP1 group had 1 patient admitted twice and 2 patients died within 3 months post discharge. This retrospective analysis showed that Cardiology Nurse Clinic reduce unplanned readmission and cholesterols. Methods had to think about to encourage CRP1 patients attend the Cardiology Nurse Clinic to continue CRP2 which protect them from another coronary attack.
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