Association Between Hospital-acquired Disability and Clinical Outcomes in Older Patients Who Underwent Cardiac Surgical

Overview

Journal Phys Ther Res

Specialty Rehabilitation Medicine

Date 2023 Dec 21

PMID 38125290

Authors

Hirokazu Sugiura

Masahiro Takahashi

Junichi Sakata

Hiroki Uchiyama

Masanori Nakamura

Affiliations

Soon will be listed here.

Abstract

Objective: This study aimed to clarify the association between hospital-acquired disability (HAD) and prognosis in older patients who underwent cardiac surgery.

Methods: This single-center, retrospective, observational study included 141 patients aged ≥65 years who underwent cardiac surgery at our hospital from November 2016 to August 2021. The primary endpoint of this study was the occurrence of major adverse cardiac and cerebrovascular events (MACCEs) within 2 years of hospital discharge. HAD was defined as a score of ≤5 on any one of the functional independence measure (FIM) subitems at discharge compared to preoperatively.

Results: MACCE was observed in 16.3%, and the incidence of MACCE was significantly higher in the HAD group than that in the non-HAD group (12.1 vs. 34.5%, log-rank, p = 0.003). HAD was also significantly associated with the MACCE (hazard ratio [HD]: 2.575, 95% confidence interval [CI]: 1.001-9.655, p = 0.046). The incidence rate of HAD was 20.6%, with age (odds ratio [OR]: 1.260, 95% CI: 1.080-1.470, p = 0.004), preoperative short physical performance battery (SPPB) score (OR: 0.462, 95% CI: 0.301-0.708, p <0.001), and postoperative delirium (OR: 6.660, 95% CI: 1.480-30.000, p = 0.014) identified as significant factors.

Conclusion: HAD is an independent predictor of MACCE in older patients who underwent cardiac surgery.

Citing Articles

The effect of frailty on postoperative recovery in patients with cardiovascular surgery.

Zengin H, Yildirim N Medicine (Baltimore). 2025; 103(52):e41151.

PMID: 39969328 PMC: 11688087. DOI: 10.1097/MD.0000000000041151.

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