Impact of maximum phonation time on postoperative dysphagia and prognosis after cardiac surgeryCentral MessagePerspective
Objective: The incidence of postoperative complications, including dysphagia, increases as the population undergoing cardiovascular surgery ages. This study aimed to explore the potential of maximum phonation time (MPT) as a simple tool for predicting postextubation dysphagia (PED) and major adverse...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-04-01
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| Series: | JTCVS Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666273624000378 |
| _version_ | 1797202975650742272 |
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| author | Masato Ogawa, PT, PhD Seimi Satomi-Kobayashi, MD, PhD Mari Hamaguchi, MD Kodai Komaki, PT Hifumi Kusu, PT Kazuhiro P. Izawa, PT, PhD Shunsuke Miyahara, MD, PhD Yoshitada Sakai, MD, PhD Ken-ichi Hirata, MD, PhD Kenji Okada, MD, PhD |
| author_facet | Masato Ogawa, PT, PhD Seimi Satomi-Kobayashi, MD, PhD Mari Hamaguchi, MD Kodai Komaki, PT Hifumi Kusu, PT Kazuhiro P. Izawa, PT, PhD Shunsuke Miyahara, MD, PhD Yoshitada Sakai, MD, PhD Ken-ichi Hirata, MD, PhD Kenji Okada, MD, PhD |
| author_sort | Masato Ogawa, PT, PhD |
| collection | DOAJ |
| description | Objective: The incidence of postoperative complications, including dysphagia, increases as the population undergoing cardiovascular surgery ages. This study aimed to explore the potential of maximum phonation time (MPT) as a simple tool for predicting postextubation dysphagia (PED) and major adverse cardiac and cerebrovascular events (MACCEs). Methods: This retrospective study included 442 patients who underwent elective cardiac surgery at a university hospital. MPT was measured before surgery, and patients were stratified into 2 groups based on normal and abnormal MPTs. Postoperative complications, including PED and MACCEs, were also investigated. Swallowing status was assessed using the Food Intake Level Scale. Results: MPT predicted PED with prevalence of 11.0% and 18.0% in the normal and abnormal MPT groups, respectively (P = .01). During the follow-up period, MACCEs developed in 17.0% of patients. Frailty, European System for Cardiac Operative Risk Evaluation II score, PED, and MPT were markedly associated with MACCEs (adjusted hazard ratios: 2.25, 1.08, 1.96, and 0.96, respectively). Mediation analysis revealed that MPT positively influenced PED and MACCEs, whereas PED positively influenced MACCEs. The trend in restricted cubic spline analysis indicated that the hazard ratio for MACCEs increased sharply when MPT was <10 seconds. Conclusions: These findings underscore the potential of MPT as a valuable tool in the preoperative assessment and management of patients undergoing cardiac surgery. By incorporating MPT into routine preoperative evaluations, clinicians can identify patients at a higher risk of PED and MACCEs, allowing for targeted interventions and closer postoperative monitoring. This may improve patient outcomes and reduce the health care costs associated with these complications. |
| first_indexed | 2024-04-24T08:11:59Z |
| format | Article |
| id | doaj.art-992af03f02f647a1ada7ec843cd8c45d |
| institution | Directory Open Access Journal |
| issn | 2666-2736 |
| language | English |
| last_indexed | 2024-04-24T08:11:59Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Open |
| spelling | doaj.art-992af03f02f647a1ada7ec843cd8c45d2024-04-17T04:49:59ZengElsevierJTCVS Open2666-27362024-04-0118123137Impact of maximum phonation time on postoperative dysphagia and prognosis after cardiac surgeryCentral MessagePerspectiveMasato Ogawa, PT, PhD0Seimi Satomi-Kobayashi, MD, PhD1Mari Hamaguchi, MD2Kodai Komaki, PT3Hifumi Kusu, PT4Kazuhiro P. Izawa, PT, PhD5Shunsuke Miyahara, MD, PhD6Yoshitada Sakai, MD, PhD7Ken-ichi Hirata, MD, PhD8Kenji Okada, MD, PhD9Department of Rehabilitation Science, Osaka Health Science University, Osaka, Japan; Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan; Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, JapanDivision of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan; Address for reprints: Seimi Satomi-Kobayashi, MD, PhD, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan.Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Hyogo, JapanDivision of Rehabilitation Medicine, Kobe University Hospital, Hyogo, JapanDivision of Rehabilitation Medicine, Kobe University Hospital, Hyogo, JapanDepartment of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, JapanDivision of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Hyogo, JapanDivision of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Hyogo, JapanDivision of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, JapanDivision of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Hyogo, JapanObjective: The incidence of postoperative complications, including dysphagia, increases as the population undergoing cardiovascular surgery ages. This study aimed to explore the potential of maximum phonation time (MPT) as a simple tool for predicting postextubation dysphagia (PED) and major adverse cardiac and cerebrovascular events (MACCEs). Methods: This retrospective study included 442 patients who underwent elective cardiac surgery at a university hospital. MPT was measured before surgery, and patients were stratified into 2 groups based on normal and abnormal MPTs. Postoperative complications, including PED and MACCEs, were also investigated. Swallowing status was assessed using the Food Intake Level Scale. Results: MPT predicted PED with prevalence of 11.0% and 18.0% in the normal and abnormal MPT groups, respectively (P = .01). During the follow-up period, MACCEs developed in 17.0% of patients. Frailty, European System for Cardiac Operative Risk Evaluation II score, PED, and MPT were markedly associated with MACCEs (adjusted hazard ratios: 2.25, 1.08, 1.96, and 0.96, respectively). Mediation analysis revealed that MPT positively influenced PED and MACCEs, whereas PED positively influenced MACCEs. The trend in restricted cubic spline analysis indicated that the hazard ratio for MACCEs increased sharply when MPT was <10 seconds. Conclusions: These findings underscore the potential of MPT as a valuable tool in the preoperative assessment and management of patients undergoing cardiac surgery. By incorporating MPT into routine preoperative evaluations, clinicians can identify patients at a higher risk of PED and MACCEs, allowing for targeted interventions and closer postoperative monitoring. This may improve patient outcomes and reduce the health care costs associated with these complications.http://www.sciencedirect.com/science/article/pii/S2666273624000378maximum phonation timedeglutition disorderscardiac surgerymajor adverse cardiac and cerebrovascular eventsprognosisfrailty |
| spellingShingle | Masato Ogawa, PT, PhD Seimi Satomi-Kobayashi, MD, PhD Mari Hamaguchi, MD Kodai Komaki, PT Hifumi Kusu, PT Kazuhiro P. Izawa, PT, PhD Shunsuke Miyahara, MD, PhD Yoshitada Sakai, MD, PhD Ken-ichi Hirata, MD, PhD Kenji Okada, MD, PhD Impact of maximum phonation time on postoperative dysphagia and prognosis after cardiac surgeryCentral MessagePerspective JTCVS Open maximum phonation time deglutition disorders cardiac surgery major adverse cardiac and cerebrovascular events prognosis frailty |
| title | Impact of maximum phonation time on postoperative dysphagia and prognosis after cardiac surgeryCentral MessagePerspective |
| title_full | Impact of maximum phonation time on postoperative dysphagia and prognosis after cardiac surgeryCentral MessagePerspective |
| title_fullStr | Impact of maximum phonation time on postoperative dysphagia and prognosis after cardiac surgeryCentral MessagePerspective |
| title_full_unstemmed | Impact of maximum phonation time on postoperative dysphagia and prognosis after cardiac surgeryCentral MessagePerspective |
| title_short | Impact of maximum phonation time on postoperative dysphagia and prognosis after cardiac surgeryCentral MessagePerspective |
| title_sort | impact of maximum phonation time on postoperative dysphagia and prognosis after cardiac surgerycentral messageperspective |
| topic | maximum phonation time deglutition disorders cardiac surgery major adverse cardiac and cerebrovascular events prognosis frailty |
| url | http://www.sciencedirect.com/science/article/pii/S2666273624000378 |
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