Association between hospital-acquired functional decline and 2-year readmission or mortality after cardiac surgery in older patients: a multicenter, prospective cohort study

Morisawa, Tomoyuki; Saitoh, Masakazu; Otsuka, Shota; Takamura, Go; Tahara, Masayuki; Ochi, Yusuke; Y, Takahashi; Iwata, K.; Oura, Keisuke; Sakurada, Koji; Takahashi, Toshio

doi:10.1007/s40520-022-02335-1

Cited by 6 publications

(3 citation statements)

References 39 publications

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“…Hospital-acquired functional decline has been reported in many previous studies [ 18 ] and is known to develop in 16–22% of patients undergoing cardiac surgery [ 11 , 19 , 20 ]. In this study, the incidence of hospital-acquired functional decline was 15.9%, which is similar to those of previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…However, all observational studies to date have involved patients with ischemic heart disease after coronary artery bypass graft surgery; no studies have been conducted on patients after cardiac surgery. Furthermore, postoperative cardiac surgery patients with hospital-acquired functional decline have been reported to have a higher risk of all-cause death and cardiovascular readmission after discharge [ 11 ], but the prognostic relevance of the introduction of phase II CR is unclear. In this study, we evaluated the role of phase II CR in determining the long-term prognosis of patients with hospital-acquired functional decline after cardiac surgery.…”

Section: Introductionmentioning

confidence: 99%

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Utility of Cardiac Rehabilitation for Long-Term Outcomes in Patients with Hospital-Acquired Functional Decline after Cardiac Surgery: A Retrospective Study

Hirakawa

Nakayama

Hori

et al. 2023

JCM

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Hospital-acquired functional decline is an important outcome that affects the long-term prognosis of patients after cardiac surgery. Phase II cardiac rehabilitation (CR) for outpatients is expected to improve prognosis; however, this is not clear in patients with hospital-acquired functional decline after cardiac surgery. Therefore, this study evaluated whether phase II CR improved the long-term prognosis of patients with hospital-acquired functional decline after cardiac surgery. This single-center, retrospective observational study included 2371 patients who required cardiac surgery. Hospital-acquired functional decline occurred in 377 patients (15.9%) after cardiac surgery. The mean follow-up period was 1219 ± 682 days in all patients, and there were 221 (9.3%) cases with major adverse cardiovascular events (MACE) after discharge during the follow-up period. The Kaplan–Meier survival curves indicated that hospital-acquired functional decline and non-phase II CR was associated with a higher incidence of MACE than other groups (log-rank, p < 0.001), additionally exhibiting prognosticating MACE in multivariate Cox regression analysis (HR, 1.59; 95% CI, 1.01–2.50; p = 0.047). Hospital-acquired functional decline after cardiac surgery and non-phase II CR were risk factors for MACE. The participation in phase II CR in patients with hospital-acquired functional decline after cardiac surgery could reduce the risk of MACE.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Utility of Cardiac Rehabilitation for Long-Term Outcomes in Patients with Hospital-Acquired Functional Decline after Cardiac Surgery: A Retrospective Study

Hirakawa

Nakayama

Hori

et al. 2023

JCM

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“…However, these patients often encounter delays in achieving acute rehabilitation goals owing to the complexity of their disabilities and the extended recovery time resulting from preexisting conditions such as sarcopenia, frailty, and multimorbidity. Hospital-acquired functional decline (HAD) affects approximately 20% of elderly patients after acute care [1], and 10-20% of elderly patients with cardiovascular disease (CVD) experience HAD [2][3][4]. For these individuals, convalescent rehabilitation hospitals play a crucial role in providing continued intensive inpatient cardiac rehabilitation (CR) as an integral component of phase 2 CR to enhance their physical function and activities of daily living (ADL).…”

Section: Introductionmentioning

confidence: 99%

Improving Respiratory Muscle Strength and Overall Function in Patients With Cardiovascular Disease Through Rehabilitation Hospitals

Matsuo,

Morisawa,

Ohtsubo

et al. 2024

Cardiol Res

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Background:The prevalence of respiratory sarcopenia and its effect on respiratory muscle strength (RMS) in patients with cardiovascular disease (CVD), who are transferred to a convalescent rehabilitation hospital after acute care and require continuous cardiac rehabilitation (CR), is currently unclear. This study aimed to assess changes in RMS, physical function, and activities of daily living (ADL) before and after CR performed in a rehabilitation hospital. Methods:Of 50 consecutive patients transferred to a rehabilitation hospital for ongoing CR, 30 fulfilled the inclusion criteria. Maximal inspiratory and expiratory pressures (MIP and MEP, respectively) were measured at transfer, and patients with decreased RMS were diagnosed with respiratory sarcopenia. RMS, physical function, exercise tolerance, ADL ability, and health-related quality of life (HR-QoL) were measured and compared at transfer and discharge. Results:The prevalence of respiratory sarcopenia at the time of transfer to the rehabilitation hospital was 93.3%. RMS assessments at transfer and discharge demonstrated significant improvements in %MIP (from 46.3±26.1% to 63.6±33.7%) and %MEP (from 44.8±17.3% to 56.6±21.8%). Short physical performance battery, gait speed, handgrip strength, and knee extension muscle strength significantly improved, along with significant prolongation of 6-min walking distance as a measure of exercise tolerance. ADL assessment using the functional independence measure revealed significant improvement, as did HR-QoL assessed according to the five-dimension, five-level, EuroQoL instrument, following CR. Conclusions:Although respiratory sarcopenia was highly prevalent among patients with CVD who required transfer to a rehabilitation hospital after acute care, continuous CR significantly improved RMS, ADL, physical function, and exercise tolerance. These findings support the continued expansion of CR, particularly in dedicated rehabilitation hospitals.

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Effect of in-patient cardiac rehabilitation at rehabilitation hospital for cardiology patients: two-center trial

Matsuo,

Morisawa,

Yamamoto

et al. 2023

Heart Vessels

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Association between hospital-acquired functional decline and 2-year readmission or mortality after cardiac surgery in older patients: a multicenter, prospective cohort study

Cited by 6 publications

References 39 publications

Utility of Cardiac Rehabilitation for Long-Term Outcomes in Patients with Hospital-Acquired Functional Decline after Cardiac Surgery: A Retrospective Study

Utility of Cardiac Rehabilitation for Long-Term Outcomes in Patients with Hospital-Acquired Functional Decline after Cardiac Surgery: A Retrospective Study

Improving Respiratory Muscle Strength and Overall Function in Patients With Cardiovascular Disease Through Rehabilitation Hospitals

Effect of in-patient cardiac rehabilitation at rehabilitation hospital for cardiology patients: two-center trial

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