TY - JOUR A1 - Salzwedel, Annett A1 - Koran, Iryna A1 - Langheim, Eike A1 - Schlitt, Axel A1 - Nothroff, Jörg A1 - Bongarth, Christa A1 - Wrenger, Markus A1 - Sehner, Susanne A1 - Reibis, Rona Katharina A1 - Wegscheider, Karl A1 - Völler, Heinz T1 - Patient-reported outcomes predict return to work and health-related quality of life six months after cardiac rehabilitation BT - Results from a German multi-centre registry (OutCaRe) JF - PLoS ONE N2 - Background Multi-component cardiac rehabilitation (CR) is performed to achieve an improved prognosis, superior health-related quality of life (HRQL) and occupational resumption through the management of cardiovascular risk factors, as well as improvement of physical performance and patients’ subjective health. Out of a multitude of variables gathered at CR admission and discharge, we aimed to identify predictors of returning to work (RTW) and HRQL 6 months after CR. Design Prospective observational multi-centre study, enrolment in CR between 05/2017 and 05/2018. Method Besides general data (e.g. age, sex, diagnoses), parameters of risk factor management (e.g. smoking, hypertension), physical performance (e.g. maximum exercise capacity, endurance training load, 6-min walking distance) and patient-reported outcome measures (e.g. depression, anxiety, HRQL, subjective well-being, somatic and mental health, pain, lifestyle change motivation, general self-efficacy, pension desire and self-assessment of the occupational prognosis using several questionnaires) were documented at CR admission and discharge. These variables (at both measurement times and as changes during CR) were analysed using multiple linear regression models regarding their predictive value for RTW status and HRQL (SF-12) six months after CR. Results Out of 1262 patients (54±7 years, 77% men), 864 patients (69%) returned to work. Predictors of failed RTW were primarily the desire to receive pension (OR = 0.33, 95% CI: 0.22–0.50) and negative self-assessed occupational prognosis (OR = 0.34, 95% CI: 0.24–0.48) at CR discharge, acute coronary syndrome (OR = 0.64, 95% CI: 0.47–0.88) and comorbid heart failure (OR = 0.51, 95% CI: 0.30–0.87). High educational level, stress at work and physical and mental HRQL were associated with successful RTW. HRQL was determined predominantly by patient-reported outcome measures (e.g. pension desire, self-assessed health prognosis, anxiety, physical/mental HRQL/health, stress, well-being and self-efficacy) rather than by clinical parameters or physical performance. Conclusion Patient-reported outcome measures predominantly influenced return to work and HRQL in patients with heart disease. Therefore, the multi-component CR approach focussing on psychosocial support is crucial for subjective health prognosis and occupational resumption. Y1 - 2020 U6 - https://doi.org/10.1371/journal.pone.0232752 SN - 1932-6203 VL - 15 IS - 5 PB - Plos 1 CY - San Francisco ER - TY - GEN A1 - Salzwedel, Annett A1 - Koran, Iryna A1 - Langheim, Eike A1 - Schlitt, Axel A1 - Nothroff, Jörg A1 - Bongarth, Christa A1 - Wrenger, Markus A1 - Sehner, Susanne A1 - Reibis, Rona Katharina A1 - Wegscheider, Karl A1 - Völler, Heinz T1 - Patient-reported outcomes predict return to work and health-related quality of life six months after cardiac rehabilitation BT - Results from a German multi-centre registry (OutCaRe) T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Background Multi-component cardiac rehabilitation (CR) is performed to achieve an improved prognosis, superior health-related quality of life (HRQL) and occupational resumption through the management of cardiovascular risk factors, as well as improvement of physical performance and patients’ subjective health. Out of a multitude of variables gathered at CR admission and discharge, we aimed to identify predictors of returning to work (RTW) and HRQL 6 months after CR. Design Prospective observational multi-centre study, enrolment in CR between 05/2017 and 05/2018. Method Besides general data (e.g. age, sex, diagnoses), parameters of risk factor management (e.g. smoking, hypertension), physical performance (e.g. maximum exercise capacity, endurance training load, 6-min walking distance) and patient-reported outcome measures (e.g. depression, anxiety, HRQL, subjective well-being, somatic and mental health, pain, lifestyle change motivation, general self-efficacy, pension desire and self-assessment of the occupational prognosis using several questionnaires) were documented at CR admission and discharge. These variables (at both measurement times and as changes during CR) were analysed using multiple linear regression models regarding their predictive value for RTW status and HRQL (SF-12) six months after CR. Results Out of 1262 patients (54±7 years, 77% men), 864 patients (69%) returned to work. Predictors of failed RTW were primarily the desire to receive pension (OR = 0.33, 95% CI: 0.22–0.50) and negative self-assessed occupational prognosis (OR = 0.34, 95% CI: 0.24–0.48) at CR discharge, acute coronary syndrome (OR = 0.64, 95% CI: 0.47–0.88) and comorbid heart failure (OR = 0.51, 95% CI: 0.30–0.87). High educational level, stress at work and physical and mental HRQL were associated with successful RTW. HRQL was determined predominantly by patient-reported outcome measures (e.g. pension desire, self-assessed health prognosis, anxiety, physical/mental HRQL/health, stress, well-being and self-efficacy) rather than by clinical parameters or physical performance. Conclusion Patient-reported outcome measures predominantly influenced return to work and HRQL in patients with heart disease. Therefore, the multi-component CR approach focussing on psychosocial support is crucial for subjective health prognosis and occupational resumption. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 633 Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-469839 SN - 1866-8364 IS - 910 ER - TY - JOUR A1 - Skobel, Erik A1 - Kamke, Wolfram A1 - Bönner, Gerd A1 - Alt, Bernd A1 - Purucker, Hans-Christian A1 - Schwaab, Bernhard A1 - Einwang, Hans-Peter A1 - Schröder, Klaus A1 - Langheim, Eike A1 - Völler, Heinz A1 - Brandenburg, Alexandra A1 - Graml, Andrea A1 - Woehrle, Holger A1 - Krüger, Stefan T1 - Risk factors for, and prevalence of, sleep apnoea in cardiac rehabilitation facilities in Germany: The Reha-Sleep registry JF - European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology N2 - Aim To determine the prevalence of, and the risk factors for, sleep apnoea in cardiac rehabilitation (CR) facilities in Germany. Methods 1152 patients presenting for CR were screened for sleep-disordered breathing with 2-channel polygraphy (ApneaLink; ResMed). Parameters recorded included the apnoea-hypopnoea index (AHI), number of desaturations per hour of recording (ODI), mean and minimum nocturnal oxygen saturation and number of snoring episodes. Patients rated subjective sleep quality on a scale from 1 (poor) to 10 (best) and completed the Epworth Sleepiness Scale (ESS). Results Clinically significant sleep apnoea (AHI 15/h) was documented in 33% of patients. Mean AHI was 1416/h (range 0-106/h). Sleep apnoea was defined as being of moderate severity in 18% of patients (AHI 15-29/h) and severe in 15% (AHI 30/h). There were small, but statistically significant, differences in ESS score and subjective sleep quality between patients with and without sleep apnoea. Logistic regression model analysis identified the following as risk factors for sleep apnoea in CR patients: age (per 10 years) (odds ratio (OR) 1.51; p<0.001), body mass index (per 5 units) (OR 1.31; p=0.001), male gender (OR 2.19; p<0.001), type 2 diabetes mellitus (OR 1.45; p=0.040), haemoglobin level (OR 0.91; p=0.012) and witnessed apnoeas (OR 1.99; p<0.001). Conclusions The findings of this study indicate that more than one-third of patients undergoing cardiac rehabilitation in Germany have sleep apnoea, with one-third having moderate-to-severe SDB that requires further evaluation or intervention. Inclusion of sleep apnoea screening as part of cardiac rehabilitation appears to be appropriate. KW - Cardiac rehabilitation KW - sleep apnoea KW - sleep-disordered breathing Y1 - 2015 U6 - https://doi.org/10.1177/2047487314537916 SN - 2047-4873 SN - 2047-4881 VL - 22 IS - 7 SP - 820 EP - 830 PB - Sage Publ. CY - London ER - TY - GEN A1 - Skobel, Erik A1 - Kamke, Wolfram A1 - Bönner, Gerd A1 - Alt, Bernd A1 - Purucker, Hans-Christian A1 - Schwaab, Bernhard A1 - Einwang, Hans-Peter A1 - Schröder, Klaus A1 - Langheim, Eike A1 - Völler, Heinz A1 - Brandenburg, Alexandra A1 - Graml, Andrea A1 - Woehrle, Holger A1 - Krüger, Stefan T1 - Risk factors for, and prevalence of, sleep apnoea in cardiac rehabilitation facilities in Germany BT - the Reha-Sleep registry T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Aim To determine the prevalence of, and the risk factors for, sleep apnoea in cardiac rehabilitation (CR) facilities in Germany. Methods 1152 patients presenting for CR were screened for sleep-disordered breathing with 2-channel polygraphy (ApneaLink; ResMed). Parameters recorded included the apnoea-hypopnoea index (AHI), number of desaturations per hour of recording (ODI), mean and minimum nocturnal oxygen saturation and number of snoring episodes. Patients rated subjective sleep quality on a scale from 1 (poor) to 10 (best) and completed the Epworth Sleepiness Scale (ESS). Results Clinically significant sleep apnoea (AHI 15/h) was documented in 33% of patients. Mean AHI was 1416/h (range 0-106/h). Sleep apnoea was defined as being of moderate severity in 18% of patients (AHI 15-29/h) and severe in 15% (AHI 30/h). There were small, but statistically significant, differences in ESS score and subjective sleep quality between patients with and without sleep apnoea. Logistic regression model analysis identified the following as risk factors for sleep apnoea in CR patients: age (per 10 years) (odds ratio (OR) 1.51; p<0.001), body mass index (per 5 units) (OR 1.31; p=0.001), male gender (OR 2.19; p<0.001), type 2 diabetes mellitus (OR 1.45; p=0.040), haemoglobin level (OR 0.91; p=0.012) and witnessed apnoeas (OR 1.99; p<0.001). Conclusions The findings of this study indicate that more than one-third of patients undergoing cardiac rehabilitation in Germany have sleep apnoea, with one-third having moderate-to-severe SDB that requires further evaluation or intervention. Inclusion of sleep apnoea screening as part of cardiac rehabilitation appears to be appropriate. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 400 KW - cardiac rehabilitation KW - sleep apnoea KW - sleep-disordered breathing Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-404814 IS - 400 ER -