Drop-out predictors in cardiac rehabilitation programmes and the impact of sex differences among coronary heart disease patients in an Iranian sample: a cohort study

Clin Rehabil. 2007 Apr;21(4):362-72. doi: 10.1177/0269215507072193.

Abstract

Objective: To determine whether patients who subsequently drop out of a structured cardiac rehabilitation programme could be prospectively distinguished from those who remain in the programme based upon their initial baseline characteristics.

Design: A cohort study.

Setting: A referral rehabilitation department in a cardiovascular research and training institute.

Subjects: One thousand one hundred and fifteen coronary heart disease patients including patients with ischaemic heart disease, and those undergoing bypass surgery or percutaneous coronary interventions.

Interventions: Demographic characteristics, coronary heart disease risk factors, ejection fraction, functional capacity and laboratory tests were considered at baseline.

Main measures: Patients who completed all 24 sessions of the cardiac rehabilitation programme were compared with drop-out cases who did not.

Results: Four hundred and ninety-nine patients (44.8%) completed the whole cardiac rehabilitation programme. Women (adjusted odds ratio (AOR) 1.817, P < 0.001), older patients (AOR 1.015, P = 0.047), patients with lower risk of coronary heart disease (AOR 1.573, P = 0.008) or lower body mass index (BMI) (AOR 0.945, P = 0.001) and higher waist-to-hip ratio (AOR 12.871, P = 0.009) and those who were non-smokers (AOR 1.779, P = 0.001) were significantly more likely to complete cardiac rehabilitation.

Conclusions: Developing interventions to address special needs of young, obese, smoker male patients who have a lower waist-to-hip ratio and higher clinical risk may be important, especially in attempts to retain this high-risk group in cardiac rehabilitation therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Body Mass Index
  • Cohort Studies
  • Coronary Disease / rehabilitation*
  • Female
  • Humans
  • Iran / epidemiology
  • Logistic Models
  • Male
  • Middle Aged
  • Patient Dropouts / statistics & numerical data*
  • Risk Assessment
  • Sex Factors
  • Smoking / epidemiology
  • Waist-Hip Ratio