Six-minute walk test distance at time of hospital discharge is strongly and independently associated with all-cause mortality following cardiac surgery
Abstract We investigated the impact of distance covered in the six-minute walk test (6mWT) before being discharged from the hospital after cardiac surgery on the risk of all-cause mortality. Our study included 1127 patients who underwent cardiac surgery and then took part in a standardised physiothe...
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| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2024-01-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-024-52601-7 |
| _version_ | 1797274897808883712 |
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| author | Md Shajedur Rahman Shawon Benjumin Hsu Richard Chard Ian A. Nicholson Victoria L. Elias Lauren K. Nicola Corrina R. Moore Andrew D. Hirschhorn Louisa R. Jorm Sean F. Mungovan |
| author_facet | Md Shajedur Rahman Shawon Benjumin Hsu Richard Chard Ian A. Nicholson Victoria L. Elias Lauren K. Nicola Corrina R. Moore Andrew D. Hirschhorn Louisa R. Jorm Sean F. Mungovan |
| author_sort | Md Shajedur Rahman Shawon |
| collection | DOAJ |
| description | Abstract We investigated the impact of distance covered in the six-minute walk test (6mWT) before being discharged from the hospital after cardiac surgery on the risk of all-cause mortality. Our study included 1127 patients who underwent cardiac surgery and then took part in a standardised physiotherapist-supervised inpatient rehabilitation programme during 2007–2017. The percentage of the predicted 6mWT distance, and the lower limit of normal distance was calculated based on individual patients’ age, sex, and body mass index. We used Cox regression with adjustment for confounders to determine multivariable-adjusted hazard ratios (HRs) for mortality. Over a median follow-up period of 6.4 (IQR: 3.5–9.2) years, 15% (n = 169) patients died. We observed a strong and independent inverse association between 6mWT distance and mortality, with every 10 m increase in distance associated to a 4% reduction in mortality (HR: 0.96, 95% CI 0.94–0.98, P < 0.001). Those in the top tertile for predicted 6mWT performance had a 49% reduced risk of mortality (HR: 0.51, 95% CI 0.33–0.79) compared to those in the bottom tertile. Patients who met or exceeded the minimum normal 6mWT distance had 36% lower mortality risk (HR: 0.64, 95% CI 0.45–0.92) compared to those who did not meet this benchmark. Subgroup analysis showed that combined CABG and valve surgery patients walked less in the 6mWT compared to those undergoing isolated CABG or valve surgeries, with a significant association between 6mWT and mortality observed in the isolated procedure groups only. In conclusion, the longer the distance covered in the 6mWT before leaving the hospital, the lower the risk of mortality. |
| first_indexed | 2024-03-07T15:05:41Z |
| format | Article |
| id | doaj.art-de6909bb0b95404bb81080add55096b5 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-07T15:05:41Z |
| publishDate | 2024-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-de6909bb0b95404bb81080add55096b52024-03-05T18:55:20ZengNature PortfolioScientific Reports2045-23222024-01-0114111010.1038/s41598-024-52601-7Six-minute walk test distance at time of hospital discharge is strongly and independently associated with all-cause mortality following cardiac surgeryMd Shajedur Rahman Shawon0Benjumin Hsu1Richard Chard2Ian A. Nicholson3Victoria L. Elias4Lauren K. Nicola5Corrina R. Moore6Andrew D. Hirschhorn7Louisa R. Jorm8Sean F. Mungovan9Centre for Big Data Research in Health, University of New South WalesCentre for Big Data Research in Health, University of New South WalesDepartment of Cardiothoracic Surgery, Westmead Private HospitalDepartment of Cardiothoracic Surgery, Westmead Private HospitalWestmead Private Hospital Physiotherapy Services, Westmead Private Hospital SydneyWestmead Private Hospital Physiotherapy Services, Westmead Private Hospital SydneyWestmead Private Hospital Physiotherapy Services, Westmead Private Hospital SydneyMQ Health, Faculty of Medicine, Health and Human Sciences, Macquarie UniversityCentre for Big Data Research in Health, University of New South WalesWestmead Private Hospital Physiotherapy Services, Westmead Private Hospital SydneyAbstract We investigated the impact of distance covered in the six-minute walk test (6mWT) before being discharged from the hospital after cardiac surgery on the risk of all-cause mortality. Our study included 1127 patients who underwent cardiac surgery and then took part in a standardised physiotherapist-supervised inpatient rehabilitation programme during 2007–2017. The percentage of the predicted 6mWT distance, and the lower limit of normal distance was calculated based on individual patients’ age, sex, and body mass index. We used Cox regression with adjustment for confounders to determine multivariable-adjusted hazard ratios (HRs) for mortality. Over a median follow-up period of 6.4 (IQR: 3.5–9.2) years, 15% (n = 169) patients died. We observed a strong and independent inverse association between 6mWT distance and mortality, with every 10 m increase in distance associated to a 4% reduction in mortality (HR: 0.96, 95% CI 0.94–0.98, P < 0.001). Those in the top tertile for predicted 6mWT performance had a 49% reduced risk of mortality (HR: 0.51, 95% CI 0.33–0.79) compared to those in the bottom tertile. Patients who met or exceeded the minimum normal 6mWT distance had 36% lower mortality risk (HR: 0.64, 95% CI 0.45–0.92) compared to those who did not meet this benchmark. Subgroup analysis showed that combined CABG and valve surgery patients walked less in the 6mWT compared to those undergoing isolated CABG or valve surgeries, with a significant association between 6mWT and mortality observed in the isolated procedure groups only. In conclusion, the longer the distance covered in the 6mWT before leaving the hospital, the lower the risk of mortality.https://doi.org/10.1038/s41598-024-52601-7 |
| spellingShingle | Md Shajedur Rahman Shawon Benjumin Hsu Richard Chard Ian A. Nicholson Victoria L. Elias Lauren K. Nicola Corrina R. Moore Andrew D. Hirschhorn Louisa R. Jorm Sean F. Mungovan Six-minute walk test distance at time of hospital discharge is strongly and independently associated with all-cause mortality following cardiac surgery Scientific Reports |
| title | Six-minute walk test distance at time of hospital discharge is strongly and independently associated with all-cause mortality following cardiac surgery |
| title_full | Six-minute walk test distance at time of hospital discharge is strongly and independently associated with all-cause mortality following cardiac surgery |
| title_fullStr | Six-minute walk test distance at time of hospital discharge is strongly and independently associated with all-cause mortality following cardiac surgery |
| title_full_unstemmed | Six-minute walk test distance at time of hospital discharge is strongly and independently associated with all-cause mortality following cardiac surgery |
| title_short | Six-minute walk test distance at time of hospital discharge is strongly and independently associated with all-cause mortality following cardiac surgery |
| title_sort | six minute walk test distance at time of hospital discharge is strongly and independently associated with all cause mortality following cardiac surgery |
| url | https://doi.org/10.1038/s41598-024-52601-7 |
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