Impactos da reabilitação cardíaca fase II nas readmissões hospitalares, desfechos clínicos e funcionais após cirurgia cardíaca: revisão integrativa

Abstract

Cardiovascular disease represents the leading cause of mortality worldwide. Cardiac surgery is a relevant intervention in managing these conditions, but carries significant risk of postoperative complications and hospital readmissions. Phase II cardiac rehabilitation is recognized as an effective intervention to optimize recovery after hospital discharge. Objective: To analyze and describe the evidence on the impacts of participation in cardiac rehabilitation programs in adults undergoing cardiac surgery, evaluating its effects on clinical signs, functionality, and reduction of readmission rates after hospital discharge when compared to people who were not submitted to this intervention. Methods: Integrative review conducted according to Whittemore and Knafl methodology and PRISMA guidelines. Searches performed in four databases (PEDro, Scielo, Cochrane Library, and Web of Science) from 2015 to 2025. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Twelve studies were included, totaling 2.857 patients.Results: Eight randomized controlled trials and four observational studies were included. Cardiac rehabilitation demonstrated a significant reduction in hospital readmission rates at six to twelve months (43% vs. 59%, p = 0.03). Consistent improvements in functional capacity were observed, with increases in peak oxygen consumption (2.2–2.3 mL/kg/min) and in six-minute walk distance and physical exertion (78–169 meters, respectively). Quality-of-life outcomes were heterogeneous. Serious adverse events were rare and not related to the intervention. Conclusions: Phase II cardiac rehabilitation after cardiac surgery demonstrated significant benefits in reducing hospital readmissions and improving functional capacity in the medium term. The findings support the implementation of structured rehabilitation programs as an essential component of post-surgical continuity of care.