Factors related to physical functioning decline after cardiac surgery in older patients: A multicenter retrospective study

Abstract

Background: As few studies have examined physical functioning changes after cardiac surgery, the factors related to the decline in physical functioning remain unclear. This study aimed to investigate the factors related to physical functioning decline after cardiac surgery in older patients. Methods: The final study sample consisted of 523 older (!65 years) patients (age 74.2 AE 6.1 years, 66% male) who underwent cardiac surgery at 8 Japanese institutions. We excluded patients who were unable to walk independently or had a slow gait speed (<0.8 m/s) before surgery, and those who were unable to regain independent walking after surgery. We divided the patients into two groups, a decline-in-gaitspeed group and a non-decline-in-gait-speed group, according to whether their gait speed was less than 0.8 m/s at discharge. We analyzed patients' clinical characteristics to identify the factors that predicted the postoperative decline in gait speed. Results: Eighty-nine patients (17.0%) showed a postoperative decline in gait speed. Multivariate logistic regression analysis showed that the following factors predicted a postoperative decline in gait speed: age [odds ratio (OR) 1.06, 95% confidence interval (CI) 1.02-1.11]; estimated glomerular filtration rate (OR 0.98, CI 0.96-0.99); preoperative gait speed (OR 0.01, CI 0.00-0.08); and the postoperative day on which the patient could walk independently (OR 1.08, CI 1.02-1.14). Conclusions: Physical functioning declined in 17% of patients after surgery. The decline could be predicted by several clinical factors, including some that are modifiable. These results suggest that further interventional research on rehabilitation before and after cardiac surgery for older patients might help overcome the decline in physical functioning.

Impact of sarcopenia on the progress of cardiac rehabilitation and discharge destination after cardiovascular surgery

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Hospitalization-Associated Disability After Cardiac Surgery in Elderly Patients ― Exploring the Risk Factors Using Machine Learning Algorithms ―

“…The study protocol was approved by the Ethics Committee of Sakakibara Heart Institute (No. [17][18][19][20][21][22][23][24][25][26][27]. This study used the opt-out consent form approved by the Ethics Committee.…”

Ventilatory efficiency during ramp exercise in relation to age and sex in a healthy Japanese population

“…The results of this study enabled us to predict normal ventilatory parameter values, which can facilitate the assessment of various factors related to the severity of heart failure. This will be useful for ensuring safe cardiac rehabilitation in patients such as those who have undergone cardiac surgery [28] and consequently have breathing limitations, as well as those with hypertrophic obstructive cardiomyopathy [29], whose hemodynamics easily change with exercise.…”