Evaluación de desenlaces clínicos y paraclínicos por medio de la aplicación del PERFSCORE a pacientes con diagnóstico de infarto agudo de miocardio, que completaron fase II y III de rehabilitación cardiaca en el Hospital Militar Central durante el año 2016
DOI:
https://doi.org/10.28957/rcmfr.v28n2a5Palabras clave:
infarto agudo de miocardio, rehabilitación cardiaca, desempeño.Resumen
Se realizó un estudio observacional de corte transversal, que evaluó el desempeño del programa de rehabilitación cardiaca del Hospital Militar Central de Bogotá, por medio de la aplicación del PERFSCORE a pacientes con infarto agudo de miocardio (IAM) que durante el año 2016 ingresaron y culminaron fase II y III de rehabilitación cardiaca.
Materiales y métodos: Estudio observacional de corte transversal que incluyó 183 pacientes con diagnóstico de IAM, que requirieron manejo percutáneo o quirúrgico. La muestra fue observada al ingreso y 9 meses después de culminar fase III, se observaron variables clínicas y paraclínicas al ingreso y egreso que fueron analizadas por estadística descriptiva; así mismo se calculó el PERFSCORE que puntúa el desempeño del programa en óptimo (mayor que 28), satisfactorio (entre 22 y 28) o insatisfactorio (menor que 22).
Resultados: Se reunieron 75 pacientes que cumplieron los criterios de inclusión. Dentro de las variables de interés, se observó que hubo cambios a favor del control satisfactorio de las cifras basales de frecuencia cardiaca, tensión arterial y niveles de LDL. Así mismo, 58 pacientes (que corresponden al 77% de la muestra) obtuvieron un PERFSCORE superior a 28.
Conclusiones: Se resalta la importancia de una evaluación objetiva del desempeño de los programas de rehabilitación cardiaca como una estrategia de seguimiento a pacientes y mejoramiento de estos programas.
Referencias bibliográficas
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2015; 385(9963):117-71. https://doi.org/10.1016/S0140-6736(14)61682-2
2. Doll J. Doll JA, Hellkamp A, Thomas L, Ho PM, Kontos MC, Whooley MA, et al. Effectiveness of cardiac rehabilitation among older patients after acute myocardial infarction. Am Heart J. 2015;170:855-64. https://doi.org/10.1016/j.ahj.2015.08.001
3. Kim C, Jung H, Choi HE, Kang SH. Cardiac rehabilitation after acute myocardial infarction resuscitated from cardiac arrest. Ann Rehabil Med. 2014; 38(6):799-804. https://doi.org/10.5535/arm.2014.38.6.799
4. Enriquez R. Estratificación de riesgo en rehabilitación cardiaca. Rev. peru. cardiol. 2013;39(3): 1-8.
5. Piepoli M. 2016 European Guidelines on cardiovascular disease prevention in clinical practice. Int J Behav Med. 2017; 24(3):321–
-419. https://doi.org/10.1007/s12529-016-9583-6
6. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937-52. https://doi.org/10.1016/S0140-6736(04)170189
7. Sandesara PB, Lambert CT, Gordon NF, Fletcher GF, Franklin BA, Wenger NK, et al. Cardiac rehabilitation and risk reduction time to “Rebrand and Reinvigorate”. J Am Coll Cardiol. 2015;65(4):389-395. https://doi.org/10.1016/j.jacc.2014.10.059.
8. Maras P, Doimo S, Altinier A, Della Mattia A, Scudeller L, Sinagra G, et al. ‘PERFSCORE’ – a multidimensional score: a simple way to predict the success of cardiac rehabilitation. J Cardiovasc Med. 2017;(0):1-8. https://doi.org/10.2459/JCM.0000000000000518
9. Laslett LJ, Alagona P Jr, Clark BA 3rd, Drozda JP Jr, Saldivar F, Wilson SR, et al. The worldwide environment of cardiovascular disease: Prevalence, diagnosis, therapy, and policy issues. J Am Coll Cardiol. 2012;60(25):1-49. https://doi.org/10.1016/j.jacc.2012.11.002.
10. Mudrick D, Shaffer L, Lalonde M, Ruhil A, Lam G, Hickerson J, et al. Cardiac rehabilitation participation reduces 90-day hospital readmissions after acute myocardial infarction or percutaneous coronary intervention. JACC. 2013; 61(10):1. https://doi.org/10.1016/S0735-1097(13)61418-7
11. Edström C. Plüss CE, Billing E, Held C, Henriksson P, Kiessling A, Karlsson MR, et al. Long-term effects of an expanded cardiac rehabilitation programme after myocardial infarction or coronary artery bypass surgery: a five-year follow-up of a randomized controlled study. Clin Rehabil. 2011; 25: 79– -87. https://doi.org/10.1177/0269215510376006
12. Stamler J, Stamler R, Neaton JD, Wentworth D, Daviglus ML, Garside D. Low risk-factor profile and long-term cardiovascular and noncardiovascular mortality and life expectancy: findings for 5 large cohorts of young adult and middle-aged men and women. JAMA. 1999; 282(21):2012-8. https://doi.org/10.1001/jama.282.21.2012
13. Faxon DP, Fuster V, Libby P, Beckman JA, Hiatt WR, Thompson RW, et al. Atherosclerotic Vascular Disease Conference: Writing Group III: pathophysiology. Circulation. 2004;109(21):2617-25. https://doi.org/10 .1161/01.CIR.0000128520.37674.EF
14. Forman DE1, Rich MW, Alexander KP, Zieman S, Maurer MS, Najjar SS, et al. Cardiac care for older adults. Time for a new paradigm. J Am Coll Cardiol. 2011; 57(18):1801-10. https://doi.org/10.1016/j.jacc.2011.02.014
15. Taylor RS, Brown A, Ebrahim S, Jolliffe J, Noorani H, Rees K. et al. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and metaanalysis of randomized controlled trials. Am
J Med. 2004; 116(10):682-92. https://doi.org/10.1016j.amjmed.2004.01.009
16. Wenger NK. Current status of cardiac rehabilitation. J Am Coll Cardiol. 2008; 51(17):1619-31. https://doi.org/10.1016/j.jacc.2008.01.030
17. Suaya JA1, Stason WB, Ades PA, Normand SL, Shepard DS.. Cardiac rehabilitation and survival in older coronary patients. J Am Coll Cardiol. 2009; 54(1):25-33. https://doi.org/10.1016/j.jacc.2009.01.078
18. Belardinelli R, Paolini I, Cianci G, Piva R, Georgiou D, Purcaro A. Exercise training intervention after coronary angioplasty: the ETICA trial. J Am Coll Cardiol. 2001; 37(7):1891-900. https://doi.org/10.1016/
S0735-1097(01)01236-0
19. Goel K, Lennon RJ, Tilbury RT, Squires RW, Thomas RJ. Impact of cardiac rehabilitation on mortality and cardiovascular events after percutaneous coronary intervention in the community. Circulation. 2011;123(21):234452. https://doi.org/10.1161/CIRCULATIONAHA.110.983536
20. Hammill BG, Curtis LH, Schulman KA, Whellan DJ. Relationship between cardiac rehabilitation and long-term risks of death and myocardial infarction among elderly Medicare beneficiaries. Circulation. 2010; 63(7):802-9. https://doi.org/10.1161/CIRCULATIONAHA.109.876383
21. Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer S, et al. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke J Cereb Circ. 2016; 47(6):e98-169. https://doi.org/10.1161/STR.0000000000000098
Cómo citar
1.
Cabezas García L, Álvarez Fernández O. Evaluación de desenlaces clínicos y paraclínicos por medio de la aplicación del PERFSCORE a pacientes con diagnóstico de infarto agudo de miocardio, que completaron fase II y III de rehabilitación cardiaca en el Hospital Militar Central durante el año 2016. Rev. Colomb. Med. Fis. Rehabil. [Internet]. 2 de abril de 2019 [citado 19 de abril de 2024];28(2):109-17. Disponible en: https://revistacmfr.org/index.php/rcmfr/article/view/220
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2019-04-02
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