Clinical and sociodemographic correlates of referral for cardiac rehabilitation following cardiac revascularization in Ontario

Abstract

Objectives: Describe rates of, and examine factors affecting, referral to cardiac rehabilitation (CR) following revascularization in Ontario.

Background: CR reduces mortality following cardiac revascularization, but is largely underutilized, partly due to poor referral rates.

Methods: In this retrospective study, the sample consisted of all CR-indicated patients who underwent revascularization at the Cardiac Care Network of Ontario hospitals between October 2011 through March 2012. Referral rates were described, and multivariate analyses performed to identify disparities.

Results: Of the 3739 patients included, 51.8% were referred to CR. Patients aged ≥85 or requiring a translator, and patients with hyperlipidemia, heart failure, or comorbid pulmonary, renal or peripheral vascular disease, were significantly less likely to be referred. Patients with a history of smoking or myocardial infarction, or who underwent coronary artery bypass graft surgery, were significantly more likely.

Conclusions: A national policy statement recommends 85% referral of indicated patients to CR, a target currently missed by almost 35%.

Keywords: CABG; CCN; CR; CVD; Cardiac Care Network of Ontario; Cardiovascular diseases; Myocardial revascularization; PCI; Referral and consultation; Rehabilitation; cardiac rehabilitation; cardiovascular disease; coronary artery bypass graft; percutaneous coronary intervention.