Association between hospital-acquired functional decline and 2-year readmission or mortality after cardiac surgery in older patients: a multicenter, prospective cohort study.
Cardiac surgery
Hospital-acquired functional decline
Older patient
Outcome assessment
Journal
Aging clinical and experimental research
ISSN: 1720-8319
Titre abrégé: Aging Clin Exp Res
Pays: Germany
ID NLM: 101132995
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
received:
24
11
2022
accepted:
20
12
2022
pubmed:
12
1
2023
medline:
17
3
2023
entrez:
11
1
2023
Statut:
ppublish
Résumé
Hospital-acquired functional decline (HAFD) is a new predictor of poor prognosis in hospitalized older patients. We aimed to assess the impact of HAFD on the prognosis of older cardiac surgical patients 2 years after discharge. This multicenter prospective cohort study assessed 293 patients with cardiac disease aged ≥ 65 years who underwent cardiac surgery at 7 Japanese hospitals between June 2017 and June 2018. The primary endpoint was the composite outcome of cardiovascular-related readmission and all-cause mortality 2 years after discharge. HAFD was assessed using the total Short Physical Performance Battery at hospital discharge. The primary outcome was observed in 17.3% of the 254 included patients, and HAFD was significantly associated with the primary outcome. Female sex (hazard ratio [HR], 2.451; 95% confidence interval [CI] 1.232-4.878; P = 0.011), hemoglobin level (HR, 0.839; 95% CI 0.705-0.997; P = 0.046), preoperative frailty (HR, 2.391; 95% CI 1.029-5.556; P = 0.043), and HAFD (HR, 2.589; 95% CI 1.122-5.976; P = 0.026) were independently associated with the primary outcome. The incidence rate of HAFD was 22%, with female sex (odds ratio [OR], 1.912; 95% CI 1.049-3.485; P = 0.034), chronic obstructive pulmonary disease (OR, 3.958; 95% CI 1.413-11.086; P = 0.009), and the time interval (days) between surgery and the start of ambulation (OR, 1.260, 95% CI 1.057-1.502; P = 0.010) identified as significant factors. HAFD was found to be an independent prognostic determinant of the primary outcome 2 years after discharge. HAFD prevention should be prioritized in the hospital care of older cardiac surgery patients.
Sections du résumé
BACKGROUND
BACKGROUND
Hospital-acquired functional decline (HAFD) is a new predictor of poor prognosis in hospitalized older patients.
AIMS
OBJECTIVE
We aimed to assess the impact of HAFD on the prognosis of older cardiac surgical patients 2 years after discharge.
METHODS
METHODS
This multicenter prospective cohort study assessed 293 patients with cardiac disease aged ≥ 65 years who underwent cardiac surgery at 7 Japanese hospitals between June 2017 and June 2018. The primary endpoint was the composite outcome of cardiovascular-related readmission and all-cause mortality 2 years after discharge. HAFD was assessed using the total Short Physical Performance Battery at hospital discharge.
RESULTS
RESULTS
The primary outcome was observed in 17.3% of the 254 included patients, and HAFD was significantly associated with the primary outcome. Female sex (hazard ratio [HR], 2.451; 95% confidence interval [CI] 1.232-4.878; P = 0.011), hemoglobin level (HR, 0.839; 95% CI 0.705-0.997; P = 0.046), preoperative frailty (HR, 2.391; 95% CI 1.029-5.556; P = 0.043), and HAFD (HR, 2.589; 95% CI 1.122-5.976; P = 0.026) were independently associated with the primary outcome. The incidence rate of HAFD was 22%, with female sex (odds ratio [OR], 1.912; 95% CI 1.049-3.485; P = 0.034), chronic obstructive pulmonary disease (OR, 3.958; 95% CI 1.413-11.086; P = 0.009), and the time interval (days) between surgery and the start of ambulation (OR, 1.260, 95% CI 1.057-1.502; P = 0.010) identified as significant factors.
DISCUSSION
CONCLUSIONS
HAFD was found to be an independent prognostic determinant of the primary outcome 2 years after discharge.
CONCLUSION
CONCLUSIONS
HAFD prevention should be prioritized in the hospital care of older cardiac surgery patients.
Identifiants
pubmed: 36629994
doi: 10.1007/s40520-022-02335-1
pii: 10.1007/s40520-022-02335-1
doi:
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
649-657Subventions
Organisme : Japan Society for the Promotion of Science
ID : 17K01544
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
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