TY  - JOUR
A1  - Röhrig, Bernd
A1  - Salzwedel, Annett
A1  - Linck-Eleftheriadis, Sigrid
A1  - Völler, Heinz
A1  - Nosper, Manfred
T1  - Outcome Based Center Comparisons in Inpatient Cardiac Rehabilitation Results from the EVA-Reha (R) Cardiology Project
JF  - Die Rehabilitation : Zeitschrift für Praxis und Forschung in der Rehabilitation
N2  - Background: So far, for center comparisons in inpatient cardiac rehabilitation (CR), the objective outcome quality was neglected because of challenges in quantifying the overall success of CR. In this article, a multifactorial benchmark model measuring the individual rehabilitation success is presented.
 Methods: In 21 rehabilitation centers, 5 123 patients were consecutively enrolled between 01/2010 and 12/2012 in the prospective multicenter registry EVA-Reha (R) Cardiology. Changes in 13 indicators in the areas cardiovascular risk factors, physical performance and subjective health during rehabilitation were evaluated according to levels of severity. Changes were only rated for patients who needed a medical intervention. Additionally, the changes had to be clinically relevant. Therefore Minimal Important Differences (MID) were predefined. Ratings were combined to a single score, the multiple outcome criterion (MEK).
 Results: The MEK was determined for all patients (71.7 +/- 7.4 years, 76.9 % men) and consisted of an average of 5.6 indicators. After risk adjustment for sociodemographic and clinical baseline parameters, MEK was used for center ranking. In addition, individual results of indicators were compared with means of all study sites.
 Conclusion: With the method presented here, the outcome quality can be quantified and outcome-based comparisons of providers can be made.
KW  - outcome quality
KW  - quality assurance
KW  - cardiac rehabilitation
KW  - benchmark
KW  - profiling
Y1  - 2015
U6  - https://doi.org/10.1055/s-0034-1395556
SN  - 0034-3536
SN  - 1439-1309
VL  - 54
IS  - 1
SP  - 45
EP  - 52
PB  - Thieme
CY  - Stuttgart
ER  - 
TY  - JOUR
A1  - Heidler, Maria-Dorothea
A1  - Bidu, Laura
A1  - Friedrich, Nele
A1  - Völler, Heinz
T1  - Oral feeding of long-term ventilated patients with a tracheotomy tube. Underestimated danger of dysphagia
JF  - Medizinische Klinik, Intensivmedizin und Notfallmedizin
N2  - In long-term mechanically ventilated patients, dysphagia is a common and potentially life-threatening complication, which can lead to aspiration and pneumonia. Nevertheless, many intensive care unit (ICU) patients are fed by mouth without evaluation of their deglutition capability.
 The goal of this work was to evaluate the prevalence of aspiration due to swallowing disorders in long-term ventilated patients who were fed orally in the ICU while having a blocked tracheotomy tube.
 In all, 43 patients participated-each underwent a fiberoptic investigation of deglutition on the day of admission to the rehabilitation clinic.
 A total of 65 % of the patients aspirated, 71 % of these silently. There were no associations between aspiration and any of the following: gender, indication for mechanical ventilation (underlying disease) or the duration of intubation and ventilation by tracheotomy tube. However, the association between aspiration and age was statistically significant (p = 0.041). Aspirating patients were older (arithmetic mean = 70 years, median = 74 years) than patients who did not aspirate (arithmetic mean = 66 years, median = 67 years).
 Intubation and add-on tracheotomies can lead to potentially life-threatening swallowing disorders that cause aspiration, independent of the underlying disease. Before feeding long-term mechanically ventilated patients by mouth, their ability to swallow needs to be investigated using fiberoptic endoscopic evaluation of swallowing (FEES) or a saliva dye test, if a cuff deflation and the use of a speaking valve are possible during spontaneous respiration.
KW  - Intubation
KW  - Tracheotomy
KW  - Ventilation
KW  - Endoscopy
KW  - Respiratory aspiration
Y1  - 2015
U6  - https://doi.org/10.1007/s00063-014-0397-5
SN  - 2193-6218
VL  - 110
IS  - 1
SP  - 55
EP  - 60
PB  - Springer
CY  - New York
ER  - 
TY  - JOUR
A1  - Schlitt, Axel
A1  - Kamke, Wolfram
A1  - Guha, Manju
A1  - Haberecht, Olaf
A1  - Völler, Heinz
T1  - Atrial Fibrillation: The correct Procedure in the cardiac Rehabilitation
JF  - Deutsche medizinische Wochenschrift : DMW ; Organ der Deutschen Gesellschaft für Innere Medizin (DGIM) ; Organ der Gesellschaft Deutscher Naturforscher und Ärzte (GDNÄ)
Y1  - 2015
U6  - https://doi.org/10.1055/s-0041-102733
SN  - 0012-0472
SN  - 1439-4413
VL  - 140
IS  - 13
SP  - 1006
EP  - U100
PB  - Thieme
CY  - Stuttgart
ER  -