Optimizing Risk Stratification in Cardiac Rehabilitation With Inclusion of a Comorbidity Index

Abstract

To appreciate more fully the overall complexity of disease among CR patients, ARSE should be supplemented not only with the inclusion of cardiac risk factors, as suggested in the current guidelines, but also with an assessment of noncardiac comorbidities.

Outcomes at One-Year Follow-up of Women and Men With Coronary Artery Disease Discharged From Cardiac Rehabilitation

“…19,20 Patients were classified into 3 clinical risk categories (low, intermediate, and high) as recommended by the American Association of Cardiovascular and Pulmonary Rehabilitation, 21 and a comorbidity score was calculated as previously published. 22 Depression screening using the Beck Depression Inventory II (BDI-II) was added to the database in October 1998. 23 Patients' current physical activity pattern was assessed by self-reported minutes per week (at least 10 minutes duration) engaged in moderate and/or vigorous activities, and the results are expressed in metabolic equivalent hours (METhrs).…”

Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular disease (Part III)

“…35,143 This may be explained by associated comorbidities, in that elderly patients more often have multiple comorbidities such as peripheral vascular disease, orthopaedic disease, and arthritis that -in addition to skeletal muscle deconditioning -negatively influence exercise capacity and prognosis. 144 Exercise modification in respect of comorbidity may be required to improve health outcome and maintain adherence. 145 However, older patients (>65 years of age) also strongly benefit from structured exercise training (including resistance training) with respect to aerobic exercise capacity, attenuation of age-related loss of aerobic fitness, body strength, physical function, heart rate recovery, improvement of cardiovascular risk factors, psychological measures (depression, anxiety, somatization, hostility), quality of life, and participation, and, finally, a reduction of hospitalization.…”

AACVPR/ACC/AHA 2007 Performance Measures on Cardiac Rehabilitation for Referral to and Delivery of Cardiac Rehabilitation/Secondary Prevention Services

“…However, 1 study found that a combination of the AACVPR criteria with a comorbidity index helped improve the accuracy of risk stratification, particularly among female patients (55). A significant limitation to these studies is the fact that patients identified at high risk undergo additional evaluation and treatment to lower their risk, thereby dampening the ability of such screening measures to accurately identify individuals at increased risk of adverse cardiovascular events.…”