@article{SalzwedelHeidlerHauboldetal.2017,
  author    = {Salzwedel, Annett and Heidler, Maria-Dorothea and Haubold, Kathrin and Schikora, Martin and Reibis, Rona Katharina and Wegscheider, Karl and J{\"o}bgens, Michael and V{\"o}ller, Heinz},
  title     = {Prevalence of mild cognitive impairment in employable patients after acute coronary event in cardiac rehabilitation},
  series = {Vascular Health and Risk Management},
  volume    = {13},
  journal   = {Vascular Health and Risk Management},
  publisher = {Dove Medical Press Ltd},
  address   = {Albany, Auckland},
  issn      = {1176-6344},
  doi       = {10.2147/VHRM.S121086},
  pages     = {55 -- 60},
  year      = {2017},
  abstract  = {Introduction: Adequate cognitive function in patients is a prerequisite for successful implementation of patient education and lifestyle coping in comprehensive cardiac rehabilitation (CR) programs. Although the association between cardiovascular diseases and cognitive impairments (CIs) is well known, the prevalence particularly of mild CI in CR and the characteristics of affected patients have been insufficiently investigated so far. Methods: In this prospective observational study, 496 patients (54.5 ± 6.2 years, 79.8\% men) with coronary artery disease following an acute coronary event (ACE) were analyzed. Patients were enrolled within 14 days of discharge from the hospital in a 3-week inpatient CR program. Patients were tested for CI using the Montreal Cognitive Assessment (MoCA) upon admission to and discharge from CR. Additionally, sociodemographic, clinical, and physiological variables were documented. The data were analyzed descriptively and in a multivariate stepwise backward elimination regression model with respect to CI. Results: At admission to CR, the CI (MoCA score < 26) was determined in 182 patients (36.7\%). Significant differences between CI and no CI groups were identified, and CI group was associated with high prevalence of smoking (65.9 vs 56.7\%, P = 0.046), heavy (physically demanding) workloads (26.4 vs 17.8\%, P < 0.001), sick leave longer than 1 month prior to CR (28.6 vs 18.5\%, P = 0.026), reduced exercise capacity (102.5 vs 118.8 W, P = 0.006), and a shorter 6-min walking distance (401.7 vs 421.3 m, P = 0.021) compared to no CI group. The age- and education-adjusted model showed positive associations with CI only for sick leave more than 1 month prior to ACE (odds ratio [OR] 1.673, 95\% confidence interval 1.07-2.79; P = 0.03) and heavy workloads (OR 2.18, 95\% confidence interval 1.42-3.36; P < 0.01). Conclusion: The prevalence of CI in CR was considerably high, affecting more than one-third of cardiac patients. Besides age and education level, CI was associated with heavy workloads and a longer sick leave before ACE.},
  language  = {en}
}
@article{SalzwedelHeidlerMengetal.2020,
  author    = {Salzwedel, Annett and Heidler, Maria-Dorothea and Meng, Karin and Schikora, Martin and Wegscheider, Karl and Reibis, Rona Katharina and V{\"o}ller, Heinz},
  title     = {Impact of cognitive performance on disease-related knowledge six months after multi-component rehabilitation in patients after an acute cardiac event},
  series = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology},
  volume    = {26},
  journal   = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology},
  number    = {1},
  publisher = {Sage Publ.},
  address   = {London},
  issn      = {2047-4873},
  doi       = {10.1177/2047487318791609},
  pages     = {46 -- 55},
  year      = {2020},
  abstract  = {Background Although associations between cardiovascular diseases and cognitive impairment are well known, the impact of cognitive performance on the success of patient education as a core component of cardiac rehabilitation remains insufficiently investigated so far. Design Prospective observational study in two inpatient cardiac rehabilitation centres between September 2014 and August 2015 with a follow-up six months after cardiac rehabilitation. Method At admission to and discharge from cardiac rehabilitation, the cognitive performance of 401 patients (54.5 ± 6.3 years, 80\% men) following an acute coronary syndrome and/or coronary artery bypass graft was tested using the Montreal Cognitive Assessment. Patients' disease-related knowledge was determined using a quiz (22 items for medical knowledge and 12 items for healthy lifestyle and behaviour) at both times and at follow-up. The change in knowledge after cardiac rehabilitation was analysed in multivariable regression models. Potentially influencing parameters (e.g. level of education, medication, cardiovascular risk factors, coronary artery bypass graft, comorbidities, exercise capacity) were considered. Results During cardiac rehabilitation, disease-related knowledge was significantly enhanced in both scales. At follow-up, the average level of medical knowledge was significantly reduced, while lifestyle knowledge remained at a stable level. The maintenance of knowledge after cardiac rehabilitation was predominantly predicted by prior knowledge, cognitive performance at discharge from cardiac rehabilitation and, in the case of medical knowledge, by coronary artery bypass graft. Conclusion Patient education in cardiac rehabilitation led to enhanced disease-related knowledge, but the maintenance of this essentially depended on patients' cognitive performance, especially after coronary artery bypass graft. Therefore, patient education concepts in cardiac rehabilitation should be reconsidered and adjusted as needed.},
  language  = {en}
}
@article{SalzwedelReibisHeidleretal.2019,
  author    = {Salzwedel, Annett and Reibis, Rona Katharina and Heidler, Maria-Dorothea and Wegscheider, Karl and V{\"o}ller, Heinz},
  title     = {Determinants of Return to Work After Multicomponent Cardiac Rehabilitation},
  series = {Archives of Physical Medicine and Rehabilitation},
  volume    = {100},
  journal   = {Archives of Physical Medicine and Rehabilitation},
  number    = {12},
  publisher = {Elsevier},
  address   = {Philadelphia},
  issn      = {0003-9993},
  doi       = {10.1016/j.apmr.2019.04.003},
  pages     = {2399 -- 2402},
  year      = {2019},
  abstract  = {Objectives: To explore predictors of return to work in patients after acute coronary syndrome and coronary artery bypass grafting, taking into account cognitive performance, depression, physical capacity, and self-assessment of the occupational prognosis. Design: Observational, prospective, bicentric. Setting: Postacute 3-week inpatient cardiac rehabilitation (CR). Participants: Patients (N=401) <65 years of age (mean 54.5 +/- 6.3y), 80\% men. Interventions: Not applicable. Main Outcome Measures: Status of return to work (RTW) 6 months after discharge from CR. Results: The regression model for RTW showed negative associations for depression (odds ratio 0.52 per SD, 95\% confidence interval 0.36-0.76, P=.001), age (odds ratio 0.72, 95\% confidence interval 0.52-1.00, P=.047), and in particular for a negative subjective occupational prognosis (expected incapacity for work odds ratio 0.19, 95\% confidence interval 0.06-0.59, P=.004; unemployment odds ratio 0.08, 95\% confidence interval 0.01-0.72, P=.024; retirement odds ratio 0.07, 95\% confidence interval 0.01-0.067, P=.021). Positive predictors were employment before the cardiac event (odds ratio 9.66, 95\% confidence interval 3.10-30.12, P<.001), capacity to work (fit vs unfit) at discharge from CR (odds ratio 3.15, 95\% confidence interval 1.35-7.35, P=.008), and maximum exercise capacity (odds ratio 1.49, 95\% confidence interval 1.06-2.11, P=.022). Cognitive performance had no effect.},
  language  = {en}
}
@article{HeidlerSalzwedelJoebgesetal.2018,
  author    = {Heidler, Maria-Dorothea and Salzwedel, Annett and J{\"o}bges, Michael and L{\"u}ck, Olaf and Dohle, Christian and Seifert, Michael and von Helden, Andrea and Hollweg, Wibke and V{\"o}ller, Heinz},
  title     = {Decannulation of tracheotomized patients after long-term mechanical ventilation - results of a prospective multicentric study in German neurological early rehabilitation hospitals},
  series = {BMC Anesthesiology},
  volume    = {18},
  journal   = {BMC Anesthesiology},
  publisher = {BMC},
  address   = {London},
  issn      = {1471-2253},
  doi       = {10.1186/s12871-018-0527-3},
  pages     = {7},
  year      = {2018},
  abstract  = {Background: In the course of neurological early rehabilitation, decannulation is attempted in tracheotomized patients after weaning due to its considerable prognostic significance. We aimed to identify predictors of a successful tracheostomy decannulation. Methods: From 09/2014 to 03/2016, 831 tracheotomized and weaned patients (65.4 +/- 12.9 years, 68\% male) were included consecutively in a prospective multicentric observation study. At admission, sociodemographic and clinical data (e.g. relevant neurological and internistic diseases, duration of mechanical ventilation, tracheotomy technique, and nutrition) as well as functional assessments (Coma Recovery Scale-Revised (CRS-R), Early Rehabilitation Barthel Index, Bogenhausener Dysphagia Score) were collected. Complications and the success of the decannulation procedure were documented at discharge. Results: Four hundred seventy patients (57\%) were decannulated. The probability of decannulation was significantly negatively associated with increasing age (OR 0.68 per SD = 12.9 years, p < 0.001), prolonged duration of mechanical ventilation (OR 0.57 per 33.2 days, p < 0.001) and complications. An oral diet (OR 3.80; p < 0.001) and a higher alertness at admission (OR 3.07 per 7.18 CRS-R points; p < 0.001) were positively associated. Conclusions: This study identified practically measurable predictors of decannulation, which in the future can be used for a decannulation prognosis and supply optimization at admission in the neurological early rehabilitation clinic.},
  language  = {en}
}