Decision tree analysis of compliance trajectories and influencing factors in cardiac rehabilitation after transcatheter aortic valve replacement

Fu Jue; Guan Yuzhen

doi:10.13498/j.cnki.chin.j.ecc.2025.01.11

Abstract：Objective To explore the differences in the trajectories of cardiac rehabilitation compliance among patients with various degrees of aortic stenosis(AS)after undergoing transcatheter aortic valve replacement(TAVR)and analyze the influencing factors,aiming to provide a reference for improving rehabilitation exercise compliance among AS patients post-TAVR.Methods A random convenience sampling method was employed to select 182 patients with AS who underwent TAVR as the study subjects.The patients were surveyed using a general information questionnaire,Hospital Anxiety and Depression Scale Cardiac Rehabilitation Adherence Scale,Illness Perception Questionnaire,and Cardiac Rehabilitation Information Awareness Questionnaire.Additionally,the patients'cardiac rehabilitation adherence levels were followed up at the time of discharge,1 month,3 months,and 6 months post-discharge.Latent Class Growth Modeling was utilized to identify subgroups of cardiac rehabilitation adherence,and a decision tree model was employed to analyze the core influencing factors of these subgroups.Results AS patients with cardiac rehabilitation compliance after TAVR were divided into two potential categories:increased cardiac rehabilitation compliance group(75.82%)and decreased cardiac rehabilitation compliance group(24.18%).Smoking history,educational level,knowledge of cardiac rehabilitation information,number of combined diseases,good perception of disease and sedentary habits were all influencing factors on the change trajectory of cardiac rehabilitation compliance of AS patients after TAVR.Among them,the score of cardiac rehabilitation information awareness was the most important influencing factor,and the information gain was 0.530.Conclusion The cardiac rehabilitation compliance of AS patients after TAVR shows different change tracks.Medical staff can develop intervention programs focusing on improving the cardiac rehabilitation information awareness score to improve the cardiac rehabilitation compliance level of AS patients after TAVR.