[Effects of digital-driven cardiac rehabilitation on clinical outcomes in patients undergoing transcatheter aortic valve replacement].
Abstract
Objectives
To evaluate the effects of digital-driven cardiac rehabilitation on clinical outcomes in patients undergoing transcatheter aortic valve replacement (TAVR).
Methods
We retrospectively analyzed data from 1,012 patients who underwent TAVR at the Second Affiliated Hospital, Zhejiang University School of Medicine, between March 2013 and January 2023. Patients receiving conventional rehabilitation were assigned to the control group, whereas those receiving a digital-driven cardiac rehabilitation program, comprising preoperative screening and functional preparation, intraoperative eligibility assessment, postoperative stepwise rehabilitation management, and intelligent home-based rehabilitation, were assigned to the intervention group. Propensity score matching was performed to adjust for baseline confounding. Postoperative intensive care unit (ICU) stay and hospital stay, the incidence of cardiovascular and cerebrovascular adverse events at 30 days, 1 year, and 2 years after TAVR, and functional outcomes, including the 5-meter walk test, 6-minute walk test, and Katz Index, were compared between the two groups.
Results
After propensity score matching, 251 patients were included in each group. Compared with the control group, the intervention group had significantly shorter postoperative ICU stays [0 (0, 0) h vs. 0 (0, 1) h, P<0.01] and postoperative hospital stays [3 (1, 7) days vs. 8 (7, 11) days, P<0.01]. The time required to complete the 5-meter walk test was significantly shorter in the intervention group than in the control group at 30 days, 1 year, and 2 years after TAVR (all P<0.01). No apparent increase in the incidence of adverse events was observed in the intervention group at 30 days, 1 year, or 2 years after TAVR.
Conclusions
The present findings suggest that digital-driven cardiac rehabilitation may shorten hospital stay and improve selected functional outcomes in patients undergoing TAVR without an observed increase in postoperative cardiovascular and cerebrovascular adverse events.