@article{SalzwedelWegscheiderHerichetal.2015,
  author    = {Salzwedel, Annett and Wegscheider, Karl and Herich, Lena and Rieck, Angelika and Strandt, Gert and V{\"o}ller, Heinz},
  title     = {Impact of clinical and sociodemographic patient characteristics on the outcome of cardiac rehabilitation in older patients},
  series = {Aging clinical and experimental research},
  volume    = {27},
  journal   = {Aging clinical and experimental research},
  number    = {3},
  publisher = {Springer},
  address   = {New York},
  issn      = {1594-0667},
  doi       = {10.1007/s40520-014-0283-2},
  pages     = {315 -- 321},
  year      = {2015},
  abstract  = {Background Cardiac rehabilitation (CR) seeks to simultaneously improve several outcome parameters related to patient risk factors, exercise capacity and subjective health. A single score, the multiple outcome criterion (MOC), comprised of alterations in 13 outcome variables was used to measure the overall success of CR in an older population. As this success depends on the older patient's characteristics at the time of admission to CR, we attempted to determine the most important influences. Methods The impact of baseline characteristics on the success of CR, measured by MOC, was analysed using a mixed model for 1,220 older patients (70.9 +/- A 7.0 years, 78.3 \% men) who enrolled in 12 CR clinics. A multitude of potentially influential baseline patient characteristics was considered including sociodemographic variables, comorbidity, duration of hospital stay, exercise capacity, cardiovascular risk factors, emotional status, and laboratory and echocardiographic data. Results Overall, CR was successful, as indicated by the mean value of the MOC (0.6 +/- A 0.45; min -1.0, max 2.0; positive values denoting improvement, negative ones deterioration). Examples of association with negative MOC values included smoking (MOC -0.15, p < 0.001), female gender (MOC -0.07, p = 0.049), and a longer hospital stay (MOC -0.03, p = 0.03). An example of association with positive MOC value was depression score (MOC 0.06, p = 0.003). Further associations included maximal exercise capacity, blood pressure, heart rate and the rehabilitation centre attended. Conclusion Our results emphasize the necessity to take into consideration baseline characteristics when evaluating the success of CR and setting treatment targets for older patients.},
  language  = {en}
}
@article{SanchezThomasDeekenetal.2019,
  author    = {S{\´a}nchez, Alba and Thomas, Christine and Deeken, Friederike and Wagner, S{\"o}ren and Kl{\"o}ppel, Stefan and Kentischer, Felix and von Arnim, Chrstine A. F. and Denkinger, Michael and Conzelmann, Lars O. and Biermann-Stallwitz, Janine and Joos, Stefanie and Sturm, Heidrun and Metz, Brigitte and Auer, Ramona and Skrobik, Yoanna and Eschweiler, Gerhard W. and Rapp, Michael Armin},
  title     = {Patient safety, cost-effectiveness, and quality of life},
  series = {Trials},
  volume    = {20},
  journal   = {Trials},
  number    = {71},
  publisher = {BioMed Central},
  address   = {London},
  issn      = {1468-6694},
  doi       = {10.1186/s13063-018-3148-8},
  pages     = {15},
  year      = {2019},
  abstract  = {Background Postoperative delirium is a common disorder in older adults that is associated with higher morbidity and mortality, prolonged cognitive impairment, development of dementia, higher institutionalization rates, and rising healthcare costs. The probability of delirium after surgery increases with patients' age, with pre-existing cognitive impairment, and with comorbidities, and its diagnosis and treatment is dependent on the knowledge of diagnostic criteria, risk factors, and treatment options of the medical staff. In this study, we will investigate whether a cross-sectoral and multimodal intervention for preventing delirium can reduce the prevalence of delirium and postoperative cognitive decline (POCD) in patients older than 70 years undergoing elective surgery. Additionally, we will analyze whether the intervention is cost-effective. Methods The study will be conducted at five medical centers (with two or three surgical departments each) in the southwest of Germany. The study employs a stepped-wedge design with cluster randomization of the medical centers. Measurements are performed at six consecutive points: preadmission, preoperative, and postoperative with daily delirium screening up to day 7 and POCD evaluations at 2, 6, and 12 months after surgery. Recruitment goals are to enroll 1500 patients older than 70 years undergoing elective operative procedures (cardiac, thoracic, vascular, proximal big joints and spine, genitourinary, gastrointestinal, and general elective surgery procedures. Discussion Results of the trial should form the basis of future standards for preventing delirium and POCD in surgical wards. Key aims are the improvement of patient safety and quality of life, as well as the reduction of the long-term risk of conversion to dementia. Furthermore, from an economic perspective, we expect benefits and decreased costs for hospitals, patients, and healthcare insurances. Trial registration German Clinical Trials Register, DRKS00013311. Registered on 10 November 2017.},
  language  = {en}
}
@misc{SanchezThomasDeekenetal.2019,
  author    = {S{\´a}nchez, Alba and Thomas, Christine and Deeken, Friederike and Wagner, S{\"o}ren and Kl{\"o}ppel, Stefan and Kentischer, Felix and von Arnim, Chrstine A. F. and Denkinger, Michael and Conzelmann, Lars O. and Biermann-Stallwitz, Janine and Joos, Stefanie and Sturm, Heidrun and Metz, Brigitte and Auer, Ramona and Skrobik, Yoanna and Eschweiler, Gerhard W. and Rapp, Michael Armin},
  title     = {Patient safety, cost-effectiveness, and quality of life},
  series = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe},
  number    = {535},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-42488},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-424883},
  pages     = {15},
  year      = {2019},
  abstract  = {Background Postoperative delirium is a common disorder in older adults that is associated with higher morbidity and mortality, prolonged cognitive impairment, development of dementia, higher institutionalization rates, and rising healthcare costs. The probability of delirium after surgery increases with patients' age, with pre-existing cognitive impairment, and with comorbidities, and its diagnosis and treatment is dependent on the knowledge of diagnostic criteria, risk factors, and treatment options of the medical staff. In this study, we will investigate whether a cross-sectoral and multimodal intervention for preventing delirium can reduce the prevalence of delirium and postoperative cognitive decline (POCD) in patients older than 70 years undergoing elective surgery. Additionally, we will analyze whether the intervention is cost-effective. Methods The study will be conducted at five medical centers (with two or three surgical departments each) in the southwest of Germany. The study employs a stepped-wedge design with cluster randomization of the medical centers. Measurements are performed at six consecutive points: preadmission, preoperative, and postoperative with daily delirium screening up to day 7 and POCD evaluations at 2, 6, and 12 months after surgery. Recruitment goals are to enroll 1500 patients older than 70 years undergoing elective operative procedures (cardiac, thoracic, vascular, proximal big joints and spine, genitourinary, gastrointestinal, and general elective surgery procedures. Discussion Results of the trial should form the basis of future standards for preventing delirium and POCD in surgical wards. Key aims are the improvement of patient safety and quality of life, as well as the reduction of the long-term risk of conversion to dementia. Furthermore, from an economic perspective, we expect benefits and decreased costs for hospitals, patients, and healthcare insurances. Trial registration German Clinical Trials Register, DRKS00013311. Registered on 10 November 2017.},
  language  = {en}
}
@article{DobberkeBaritelloHadzicetal.2022,
  author    = {Dobberke, Jeanette and Baritello, Omar and Hadzic, Miralem and V{\"o}ller, Heinz and Eichler, Sarah and Salzwedel, Annett},
  title     = {Test-retest reliability of center of pressure measures for postural control assessment in older cardiac patients},
  series = {Gait \& posture : official journal of Gait and Clinical Movement Analysis Society (GCMAS) and European Society of Movement Analysis in Adults and Children (ESMAC)},
  volume    = {92},
  journal   = {Gait \& posture : official journal of Gait and Clinical Movement Analysis Society (GCMAS) and European Society of Movement Analysis in Adults and Children (ESMAC)},
  publisher = {Elsevier Science},
  address   = {Amsterdam},
  issn      = {0966-6362},
  doi       = {10.1016/j.gaitpost.2021.12.011},
  pages     = {359 -- 363},
  year      = {2022},
  abstract  = {Background Elderly patients are a growing population in cardiac rehabilitation (CR). As postural control declines with age, assessment of impaired balance is important in older CR patients in order to predict fall risk and to initiate counteracting steps. Functional balance tests are subjective and lack adequate sensitivity to small differences, and are further subject to ceiling effects. A quantitative approach to measure postural control on a continuous scale is therefore desirable. Force plates are already used for this purpose in other clinical contexts, therefore could be a promising tool also for older CR patients. However, in this population the reliability of the assessment is not fully known. Research question Analysis of test-retest reliability of center of pressure (CoP) measures for the assessment of postural control using a force plate in older CR patients. Methods 156 CR patients (> 75 years) were enrolled. CoP measures (path length (PL), mean velocity (MV), and 95\% confidence ellipse area (95CEA)) were analyzed twice with an interval of two days in between (bipedal narrow stance, eyes open (EO) and closed (EC), three trials for each condition, 30 s per trial), using a force plate. For test-retest reliability estimation absolute differences (\& UDelta;: T0-T1), intraclass correlation coefficients (ICC) with 95\% confidence intervals, standard error of measurement and minimal detectable change were calculated. Results Under EO condition ICC were excellent for PL and MV (0.95) and good for 95CEA (0.88) with \& UDelta; of 10.1 cm (PL), 0.3 cm/sec (MV) and 1.5 cm(2 )(95CEA) respectively. Under EC condition ICC were excellent (> 0.95) for all variables with larger \& UDelta; (PL: 21.7 cm; MV: 0.7 cm/sec; 95CEA: 2.4 cm(2)) Significance In older CR patients, the assessment of CoP measures using a force plate shows good to excellent test retest reliability.},
  language  = {en}
}