Lower extremity performance predicts length of hospital stay in older candidates to elective cardiac surgery

医学 心脏外科 前瞻性队列研究 外科 人口 队列 择期手术 内科学 环境卫生
作者
Samuele Baldasseroni,Mauro Di Bari,Pierluigi Stefàno,Alessandra Pratesi,Enrico Mossello,Andrea Ungar,Stefano Del Pace,Francesco Orso,Andrea Herbst,Giulia Lucarelli,Carlo Fumagalli,Giuseppe Olivo,Niccolò Marchionni
出处
期刊:Experimental Gerontology [Elsevier BV]
卷期号:164: 111801-111801
标识
DOI:10.1016/j.exger.2022.111801
摘要

Prolonged hospital stay must be considered as risk factor for poor outcomes after cardiac surgery; different variables have been advocated as predictors of in-hospital stay. Nevertheless, most patients requiring prolonged hospital stay are frail older subjects; thus, we hypothesized a significant influence of pre-operative physical performance, as a frailty measure, on in-hospital stay after elective cardiac surgery.In a prospective, single-center, cohort study we enrolled patients aged 75+ years referred to our Division of Cardiac Surgery at Careggi University Hospital, for their first elective cardiac surgery. All participants were preoperatively evaluated by a team composed by a cardiac surgeon, a cardiologist, an anaesthesist, and a geriatrician to assess global cardiac surgery risk; lower extremity performance was measured with the Short Physical Performance Battery-SPPB.A total of 518 patients were included in the study. Mean age was 79.5 ± 3.3 years; 256 (49.4%) were women. Isolated coronary by pass graft was performed in 37 patients (7.1%), isolated valve surgery in 115 (22.0%), and combined cardiac surgery procedures in 366 (70,9%). In a multivariable model, SPPB score was strongly associated with hospital length of stay both as continuous, categorized and dichotomous variable (p < 0.001; p = 0.002; p = 0.002 respectively) in all study population, and in subgroup of patients candidate to cardiac surgery considered by the Society of Thoracic Surgeons calculator score (p = 0.023; p = 0.056; p = 0.013 respectively).Our findings support the use of pre-operative SPPB evaluation before elective cardiac surgery based on the independent ability to predict length of hospital stay.
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