Are survivors of cardiac arrest provided with standard cardiac rehabilitation? – Results from a national survey of hospitals and municipalities in Denmark

Abstract

Aim: To quantify the provision of standard cardiac rehabilitation to Danish survivors of cardiac arrest at a programme level, and to analyse whether organizational factors influenced the provision. Method: We mapped the provision of cardiac rehabilitation core components to survivors of cardiac arrest and compared this with a reference group of patients after acute myocardial infarction using data from a cross-sectional programme-level survey among all hospitals ( n=34) and municipalities ( n= 98) in Denmark. Organizational factors of potential importance to service provision were considered: health care region, size of catchment area/population, type of department/municipality and socioeconomic index. Results: Response rates for the provision of each core component of cardiac rehabilitation ranged from 64% to 98%. All hospitals and municipalities provided some aspect of cardiac rehabilitation to survivors of cardiac arrest. Across hospitals, provision of four core components of cardiac rehabilitation to survivors of cardiac arrest was lower compared with post acute myocardial infarction patients: patient education (relative risk (RR) =0.45 (95% confidence interval (CI) 0.27 to 0.75)), exercise training (RR=0.69 (95% CI 0.49 to 0.98)), screening for anxiety and depression (RR=0.64 (95% CI 0.46 to 0.90) and nutritional counselling RR=0.76 (95% CI 0.62 to 0.93)). No difference was found in the provision of core components across municipalities. Overall, the provision of cardiac rehabilitation to survivors of cardiac arrest was not affected by organizational factors Conclusion: This study indicates a need for future research to inform the development, adoption and implementation of equal access to all components of cardiac rehabilitation for survivors of cardiac arrest in Denmark

Sleep in cardiac arrest survivors

“…There is reason to believe that SCA survivors share these experiences and risk long‐lasting sleep disturbances if they are not acknowledged and treated properly. Despite this, studies indicate that SCA survivors do not receive sufficient rehabilitation 16–18 . Since ICU nurses and cardiac intensive care unit (CICU) nurses work closely with patients in the acute phase after the cardiac arrest and cardiac nurses work closely with patients during follow‐up care, nurses can play a crucial role in detecting sleep impairments in SCA survivors and initiate interventions for better sleep.…”

Effectiveness of rehabilitation interventions on the secondary consequences of surviving a cardiac arrest: a systematic review and meta-analysis

“… 1 3–6 Most CA survivors will have a new or ongoing cardiac condition, 1 and therefore, be eligible for cardiac rehabilitation. 47 Neurological rehabilitation has been recommended to meet the ‘brain’ aspect of CA recovery. 3 48 This can be mild cognitive impairments in self-caring CA survivors 49 or more severe brain injury needing long-term residential care.…”

En oversigt over eksistentielle bekymringer hos hjertestopoverlevere og implikationerne for rehabilitering: Har vi brug for et nyt værktøj i værktøjskassen?

“…Internationale retningslinjer anbefaler, at hjertestopoverlevere tilbydes vurdering og rehabilitering i forhold til fysiske, kognitive og følelsesmaessige problemstillinger (Boyce et al, 2019;Nolan et al, 2021). Flertallet af disse overlevere bør også tilbydes "hjerterehabilitering" med fokus på sekundaer forebyggelse af hjertelidelser gennem motion og livsstilsaendringer (Nolan et al, 2021;Tang et al, 2021).…”