Physical performance tests and in-hospital outcomes in elective open chest heart surgery
Background: Physical performance tests are essential for a comprehensive health assessment, and have been described as predictors of disability and muscle mass decline after open chest heart surgery (OHS). We evaluated the association between physical performance tests with clinical outcomes after O...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-02-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906722002135 |
| _version_ | 1811172239863709696 |
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| author | Abisai Santana Mauro Mediano Daniel Kasal |
| author_facet | Abisai Santana Mauro Mediano Daniel Kasal |
| author_sort | Abisai Santana |
| collection | DOAJ |
| description | Background: Physical performance tests are essential for a comprehensive health assessment, and have been described as predictors of disability and muscle mass decline after open chest heart surgery (OHS). We evaluated the association between physical performance tests with clinical outcomes after OHS in younger and older patients. Moreover, the ability of physical performance tests and European System for Cardiac Operative Risk Evaluation (Euroscore II) to predict death was assessed. Methods: Elective OHS patients were evaluated before surgery with handgrip strength (HGS), 30-s Chair-Stand Test (30sCST), and timed up and go test (TUGT). The outcomes were post-surgical complications, total length of stay (LOS), time to walk (TW), time in invasive mechanical ventilation (TIMV), and in-hospital mortality. Data were stratified between patients < 60 (younger) and ≥ 60 years old (older). Results: A total of 166 patients were included in the study (older, n = 89). The only physical test associated with mortality in the adjusted models was HGS in older patients (p = 0.03). Among older patients, both Euroscore II (AUC = 0.77) and HGS (AUC = 0.80) demonstrated good ability to predict death. Combining HGS and Euroscore II did not increase accuracy for mortality prediction (AUC = 0.83). Conclusion: HGS performance was comparable to a well-established surgical risk score in evaluating in-hospital mortality after OHS, only in older patients. Functional testing before OHS could be a tool to improve risk stratification in these patients. Future intervention studies aiming to improve functional capacity before elective OHS can further clarify the impact of physical fitness in surgical recovery. |
| first_indexed | 2024-04-10T17:26:34Z |
| format | Article |
| id | doaj.art-f9fc5bf9481a485ca82aff2cde629150 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-04-10T17:26:34Z |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-f9fc5bf9481a485ca82aff2cde6291502023-02-04T04:18:03ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672023-02-0144101164Physical performance tests and in-hospital outcomes in elective open chest heart surgeryAbisai Santana0Mauro Mediano1Daniel Kasal2National Institute of Cardiology, Ministry of Health, Rio de Janeiro, BrazilNational Institute of Cardiology, Ministry of Health, Rio de Janeiro, BrazilNational Institute of Cardiology, Ministry of Health, Rio de Janeiro, Brazil; State University of Rio de Janeiro, Internal Medicine Department, Brazil; Corresponding author at: Rua das Laranjeiras 374, 22240-006 Rio de Janeiro, Brazil.Background: Physical performance tests are essential for a comprehensive health assessment, and have been described as predictors of disability and muscle mass decline after open chest heart surgery (OHS). We evaluated the association between physical performance tests with clinical outcomes after OHS in younger and older patients. Moreover, the ability of physical performance tests and European System for Cardiac Operative Risk Evaluation (Euroscore II) to predict death was assessed. Methods: Elective OHS patients were evaluated before surgery with handgrip strength (HGS), 30-s Chair-Stand Test (30sCST), and timed up and go test (TUGT). The outcomes were post-surgical complications, total length of stay (LOS), time to walk (TW), time in invasive mechanical ventilation (TIMV), and in-hospital mortality. Data were stratified between patients < 60 (younger) and ≥ 60 years old (older). Results: A total of 166 patients were included in the study (older, n = 89). The only physical test associated with mortality in the adjusted models was HGS in older patients (p = 0.03). Among older patients, both Euroscore II (AUC = 0.77) and HGS (AUC = 0.80) demonstrated good ability to predict death. Combining HGS and Euroscore II did not increase accuracy for mortality prediction (AUC = 0.83). Conclusion: HGS performance was comparable to a well-established surgical risk score in evaluating in-hospital mortality after OHS, only in older patients. Functional testing before OHS could be a tool to improve risk stratification in these patients. Future intervention studies aiming to improve functional capacity before elective OHS can further clarify the impact of physical fitness in surgical recovery.http://www.sciencedirect.com/science/article/pii/S2352906722002135Open chest heart surgeryMortalityHand gripTimed up and go |
| spellingShingle | Abisai Santana Mauro Mediano Daniel Kasal Physical performance tests and in-hospital outcomes in elective open chest heart surgery International Journal of Cardiology: Heart & Vasculature Open chest heart surgery Mortality Hand grip Timed up and go |
| title | Physical performance tests and in-hospital outcomes in elective open chest heart surgery |
| title_full | Physical performance tests and in-hospital outcomes in elective open chest heart surgery |
| title_fullStr | Physical performance tests and in-hospital outcomes in elective open chest heart surgery |
| title_full_unstemmed | Physical performance tests and in-hospital outcomes in elective open chest heart surgery |
| title_short | Physical performance tests and in-hospital outcomes in elective open chest heart surgery |
| title_sort | physical performance tests and in hospital outcomes in elective open chest heart surgery |
| topic | Open chest heart surgery Mortality Hand grip Timed up and go |
| url | http://www.sciencedirect.com/science/article/pii/S2352906722002135 |
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