Drop-out predictors in cardiac rehabilitation programmes and the impact of sex differences among coronary heart disease patients in an Iranian sample: a cohort study.

OBJECTIVE To determine whether patients who subsequently drop out of a structured cardiac rehabilitation programme could be prospectively distinguished from those who remain in the programme based upon their initial baseline characteristics. DESIGN A cohort study. SETTING A referral rehabilitation department in a cardiovascular research and training institute. SUBJECTS One thousand one hundred and fifteen coronary heart disease patients including patients with ischaemic heart disease, and those undergoing bypass surgery or percutaneous coronary interventions. INTERVENTIONS Demographic characteristics, coronary heart disease risk factors, ejection fraction, functional capacity and laboratory tests were considered at baseline. MAIN MEASURES Patients who completed all 24 sessions of the cardiac rehabilitation programme were compared with drop-out cases who did not. RESULTS Four hundred and ninety-nine patients (44.8%) completed the whole cardiac rehabilitation programme. Women (adjusted odds ratio (AOR) 1.817, P < 0.001), older patients (AOR 1.015, P = 0.047), patients with lower risk of coronary heart disease (AOR 1.573, P = 0.008) or lower body mass index (BMI) (AOR 0.945, P = 0.001) and higher waist-to-hip ratio (AOR 12.871, P = 0.009) and those who were non-smokers (AOR 1.779, P = 0.001) were significantly more likely to complete cardiac rehabilitation. CONCLUSIONS Developing interventions to address special needs of young, obese, smoker male patients who have a lower waist-to-hip ratio and higher clinical risk may be important, especially in attempts to retain this high-risk group in cardiac rehabilitation therapy.