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Rehabilitation contributes to lower readmission rates for individuals with peripheral arterial disease: A retrospective observational study - 19/11/23

Doi : 10.1016/j.rehab.2023.101768 
Keisuke Suzuki a, , Tomohiko Kamo b, Ryo Momosaki c, Akira Kimura b, Takayasu Koike a, Shinichi Watanabe a, Takashi Kondo a
a Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Health Sciences, Gifu, Japan 
b Department of Physical Therapy, Faculty of Health Science, Gunma Paz University, Gunma, Japan 
c Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Mie, Japan 

Corresponding author at: Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Health Sciences, 2-92 Higashiuzura, Gifu-shi, Gifu 500-8281, Japan.Department of Physical Therapy, Faculty of RehabilitationGifu University of Health Sciences2-92 Higashiuzura, Gifu-shiGifu500-8281Japan

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Highlights

Rehabilitation is often provided for peripheral arterial disease (PAD).
Rehabilitation reduces 30-day readmissions in people with PAD.
Rehabilitation reduces 6-month readmissions in people with PAD.
Rehabilitation reduces mortality in people with PAD.
Rehabilitation interventions for people with PAD are critical.

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Abstract

Background

Non-pharmacological interventions, such as rehabilitation, are crucial for the treatment of people with peripheral arterial disease (PAD). Although several studies have shown rehabilitation is effective in improving the functional prognosis of PAD, there is currently insufficient evidence regarding its effect on readmission rates.

Objectives

To examine the impact of rehabilitation on readmission rates for people with PAD.

Methods

A retrospective analysis of the JMDC hospital database was performed on data from two groups of people aged ≥20 years who were hospitalized between 2014 and 2020 with PAD, as based on a previous diagnosis. Participants were divided according to whether they did, or did not, receive any form of rehabilitation as part of their treatment in hospital. The primary outcome was readmission rates at 30, 60, 90, and 180 days after initial admission. A one-to-one propensity score matching was used to compare readmission rates between rehabilitation and non-rehabilitation groups.

Results

We included 13,453 people with PAD, of whom 2701 pairs (5402 subjects) were selected after being matched in the rehabilitation and non-rehabilitation groups. The rehabilitation group participants had significantly lower mortality and readmission rates at 30, 60, 90, and 180 days. The odds ratios (95% confidence interval) for both groups were 0.79 (0.69–0.91; 30 days), 0.81 (0.71–0.91; 60 days), 0.78 (0.69–0.88; 90 days), and 0.79 (0.71–0.88; 180 days).

Conclusions

This large, nationwide study found that rehabilitation treatment during hospitalization was associated with lower readmission rates and mortality for people following hospitalization with PAD and supports its inclusion as a standard PAD treatment.

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Keywords : Peripheral arterial disease, Rehabilitation, Propensity score, Readmission, Mortality

Abbreviations : BMI, CVD, CI, DPC, ICD, JCS, LOS, OMC, OR, PAD, PS, QOL


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Vol 66 - N° 7

Article 101768- octobre 2023 Retour au numéro
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