Perioperative poor grip strength recovery is associated with 30-day complication rate after cardiac surgery discharge in middle-aged and older adults- a prospective observational study

Abstract Background Although perioperative care during heart surgery has improved considerably, the rate of postoperative complications has remained stable. It has not been concluded how to better apply grip strength to clinical, postoperative complications. So our study aimed at researching the best way for using grip value for predicting early postoperative complications. Methods A total of 212 patients with mean age 63.8 ± 6.3 who underwent cardiac surgery participated in our study. We analyzed the ROC curve of grip strength, grip/weight and grip recovery with complications, found the best cutoff point. Logistic regression confirmed the association between grip strength grouping and complications. Results We found that 36 patients had 30-day complications. EuroSCORE were 2.15 ± 1.52 and 2.42 ± 1.58 between normal and complication groups, respectively. The area under the receiver-operating characteristic curve (AUC) of grip recovery take the most area (0.837, p < 0.001), and the cutoff point was 83.92%. In logistic regression, lower grip recovery has higher risk impact on 30-day complications for 25.68 times than normal group, after adjusted surgery-related factors. After regrouped characteristic information by grip recovery cutoff point, we found that percentage of the estimated 6 min walk distance (41.5 vs 48.3, p = 0.028) and hospitalization time (7.2 vs 6.1, p = 0.042) had worse trends in lower recovery group. Conclusions Poor grip recovery may be related to higher risk of postoperative complications within 30 days after discharge in middle-aged and older people independent of surgical risk. The results of this study provide a reference for the development of rehabilitation programs in the early postoperative recovery, and may also be a prognostic indicator for postoperative high-risk groups. Trial registration Our research was registered on Research Registry website, the registry number was ChiCTR1800018465. Date: 2018/9/20. Status: Successful.

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Perioperative poor grip strength recovery is associated with 30-day complication rate after cardiac surgery discharge in middle-aged and older adults- a prospective observational study

10.21203/rs.2.12567/v4 ◽

2019 ◽

Author(s):

Liyuan Fu ◽

Yuanyuan Zhang ◽

Bohan Shao ◽

Xiangjing Liu ◽

Bo Yuan ◽

...

Keyword(s):

Logistic Regression ◽

Cardiac Surgery ◽

Postoperative Complications ◽

Grip Strength ◽

Heart Surgery ◽

Characteristic Curve ◽

Postoperative Recovery ◽

Cutoff Point ◽

Middle Aged ◽

Related Factors

Abstract Background: Although perioperative care during heart surgery has improved considerably, the rate of postoperative complications has remained stable. It has not been concluded how to better apply grip strength to clinical, postoperative complications. So our study aimed at researching the best way for using grip value for predicting early postoperative complications. Methods: A total of 212 patients with mean age 63.8±6.3 who underwent cardiac surgery participated in our study. We analyzed the ROC curve of grip strength, grip/weight and grip recovery with complications, found the best cutoff point. Logistic regression confirmed the association between grip strength grouping and complications. Results: We found that 36 patients had 30-day complications. EuroSCORE were 2.15±1.52 and 2.42±1.58 between normal and complication groups, respectively. The area under the receiver-operating characteristic curve (AUC) of grip recovery take the most area (0.837, p<0.001), and the cutoff point was 83.92%. In logistic regression, lower grip recovery has higher risk impact on 30-day complications for 25.68 times than normal group, after adjusted surgery-related factors. After regrouped characteristic information by grip recovery cutoff point , we found that percentage of the estimated 6 minute walk distance (41.5 vs 48.3, p=0.028) and hospitalization time (7.2 vs 6.1, p=0.042) had worse trends in lower recovery group. Conclusions: Poor grip recovery may be related to higher risk of postoperative complications within 30 days after discharge in middle-aged and older people independent of surgical risk. The results of this study provide a reference for the development of rehabilitation programs in the early postoperative recovery, and may also be a prognostic indicator for postoperative high-risk groups.

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Perioperative poor grip strength recovery is associated with 30-day complication rate after cardiac surgery discharge in middle-aged and older adults- a prospective observational study

10.21203/rs.2.12567/v3 ◽

2019 ◽

Author(s):

Liyuan Fu ◽

Yuanyuan Zhang ◽

Bohan Shao ◽

Xiangjing Liu ◽

Bo Yuan ◽

...

Keyword(s):

Logistic Regression ◽

Cardiac Surgery ◽

Postoperative Complications ◽

Grip Strength ◽

Heart Surgery ◽

Characteristic Curve ◽

Postoperative Recovery ◽

Cutoff Point ◽

Middle Aged ◽

Related Factors

Abstract Background: Although perioperative care during heart surgery has improved considerably, the rate of postoperative complications has remained stable. It has not been concluded how to better apply grip strength to clinical, postoperative complications. So our study aimed at researching the best way for using grip value for predicting early postoperative complications. Methods: A total of 212 patients with mean age 63.8±6.3 who underwent cardiac surgery participated in our study. We analyzed the ROC curve of grip strength, grip/weight and grip recovery with complications, found the best cutoff point. Logistic regression confirmed the association between grip strength grouping and complications. Results: We found that 36 patients had 30-day complications. EuroSCORE were 2.15±1.52 and 2.42±1.58 between normal and complication groups, respectively. The area under the receiver-operating characteristic curve (AUC) of grip recovery take the most area (0.837, p<0.001), and the cutoff point was 83.92%. In logistic regression, lower grip recovery has higher risk impact on 30-day complications for 25.68 times than normal group, after adjusted surgery-related factors. After regrouped characteristic information by grip recovery cutoff point , we found that percentage of the estimated 6 minute walk distance (41.5 vs 48.3, p=0.028) and hospitalization time (7.2 vs 6.1, p=0.042) had worse trends in lower recovery group. Conclusions: Poor grip recovery may be related to higher risk of postoperative complications within 30 days after discharge in middle-aged and older people independent of surgical risk. The results of this study provide a reference for the development of rehabilitation programs in the early postoperative recovery, and may also be a prognostic indicator for postoperative high-risk groups.

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Perioperative poor grip strength recovery is associated with 30-day complication rate after cardiac surgery discharge in middle-aged and older adults- an observational study

10.21203/rs.2.12567/v1 ◽

2019 ◽

Author(s):

Liyuan Fu ◽

Yuanyuan Zhang ◽

Bohan Shao ◽

Xiangjing Liu ◽

Bo Yuan ◽

...

Keyword(s):

Logistic Regression ◽

Cardiac Surgery ◽

Postoperative Complications ◽

Grip Strength ◽

Heart Surgery ◽

Characteristic Curve ◽

Cutoff Point ◽

Middle Aged ◽

Related Factors ◽

Recovery Group

Abstract Background: Although perioperative care during heart surgery has improved considerably, the rate of postoperative complications has remained stable. It has not been concluded how to better apply grip strength to clinical, postoperative complications. So our study aimed at researching the best way for using grip value for predicting early postoperative complications. Methods: Consider a total of 212 people with mean age 63.8±6.3 who underwent cardiac surgery included participated in our study. We analyzed the ROC curve of grip strength, grip/weight and grip recovery with complications, found the best cutoff point. Logistic regression confirmed the correlation between grip strength grouping and complications. Results: We found that 36 people had 30-day complications. EuroSCORE were 2.15±1.52 and 2.42±1.58 in two groups. The area under the receiver-operating characteristic curve (AUC) of grip recovery take the most area (0.837, p<0.001), and the cutoff point was 83.92%. In logistic regression, lower grip recovery has higher risk impact on 30-day complications for 25.68 times than normal group, after adjusted surgery-related factors. After relisted characteristic information with grip recovery group, found that percentage of the estimated 6MWD (41.5 vs 48.3, p=0.028) and hospitalization time (7.2 vs 6.1, p=0.042) had worse trends in lower recovery group. Conclusions: Poor grip recovery may be related to higher risk of postoperative complications within 30 days after cardiac surgery in middle-aged and older people independent of surgical risk. The results of this study provide a reference for the development of rehabilitation programs in the early postoperative recovery, and may also be a prognostic indicator for postoperative high-risk groups.

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Perioperative poor grip strength recovery is associated with 30-day complication rate after cardiac surgery discharge in middle-aged and older adults- a prospective observational study

10.21203/rs.2.12567/v2 ◽

2019 ◽

Author(s):

Liyuan Fu ◽

Yuanyuan Zhang ◽

Bohan Shao ◽

Xiangjing Liu ◽

Bo Yuan ◽

...

Keyword(s):

Logistic Regression ◽

Cardiac Surgery ◽

Postoperative Complications ◽

Grip Strength ◽

Heart Surgery ◽

Characteristic Curve ◽

Cutoff Point ◽

Middle Aged ◽

Related Factors ◽

Recovery Group

Abstract Background: Although perioperative care during heart surgery has improved considerably, the rate of postoperative complications has remained stable. It has not been concluded how to better apply grip strength to clinical, postoperative complications. So our study aimed at researching the best way for using grip value for predicting early postoperative complications. Methods: A total of 212 patients with mean age 63.8±6.3 who underwent cardiac surgery included participated in our study. We analyzed the ROC curve of grip strength, grip/weight and grip recovery with complications, found the best cutoff point. Logistic regression confirmed the correlation between grip strength grouping and complications. Results: We found that 36 patients had 30-day complications. EuroSCORE were 2.15±1.52 and 2.42±1.58 between normal and complication groups, respectively. The area under the receiver-operating characteristic curve (AUC) of grip recovery take the most area (0.837, p<0.001), and the cutoff point was 83.92%. In logistic regression, lower grip recovery has higher risk impact on 30-day complications for 25.68 times than normal group, after adjusted surgery-related factors. After relisted characteristic information with grip recovery group , found that percentage of the estimated 6MWD (41.5 vs 48.3, p=0.028) and hospitalization time (7.2 vs 6.1, p=0.042) had worse trends in lower recovery group. Conclusions: Poor grip recovery may be related to higher risk of postoperative complications within 30 days after discharge in middle-aged and older people independent of surgical risk. The results of this study provide a reference for the development of rehabilitation programs in the early postoperative recovery, and may also be a prognostic indicator for postoperative high-risk groups.

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Objective Quantification of In-Hospital Patient Mobilization after Cardiac Surgery Using Accelerometers: Selection, Use, and Analysis

Sensors ◽

10.3390/s21061979 ◽

2021 ◽

Vol 21 (6) ◽

pp. 1979

Author(s):

Frank R. Halfwerk ◽

Jeroen H. L. van Haaren ◽

Randy Klaassen ◽

Robby W. van Delden ◽

Peter H. Veltink ◽

...

Keyword(s):

Intensive Care Unit ◽

Cardiac Surgery ◽

Intensive Care ◽

Hospital Stay ◽

Intensive Care Unit Stay ◽

Heart Surgery ◽

Mixed Model ◽

Postoperative Recovery ◽

Time In Bed ◽

Surgical Ward

Cardiac surgery patients infrequently mobilize during their hospital stay. It is unclear for patients why mobilization is important, and exact progress of mobilization activities is not available. The aim of this study was to select and evaluate accelerometers for objective qualification of in-hospital mobilization after cardiac surgery. Six static and dynamic patient activities were defined to measure patient mobilization during the postoperative hospital stay. Device requirements were formulated, and the available devices reviewed. A triaxial accelerometer (AX3, Axivity) was selected for a clinical pilot in a heart surgery ward and placed on both the upper arm and upper leg. An artificial neural network algorithm was applied to classify lying in bed, sitting in a chair, standing, walking, cycling on an exercise bike, and walking the stairs. The primary endpoint was the daily amount of each activity performed between 7 a.m. and 11 p.m. The secondary endpoints were length of intensive care unit stay and surgical ward stay. A subgroup analysis for male and female patients was planned. In total, 29 patients were classified after cardiac surgery with an intensive care unit stay of 1 (1 to 2) night and surgical ward stay of 5 (3 to 6) nights. Patients spent 41 (20 to 62) min less time in bed for each consecutive hospital day, as determined by a mixed-model analysis (p < 0.001). Standing, walking, and walking the stairs increased during the hospital stay. No differences between men (n = 22) and women (n = 7) were observed for all endpoints in this study. The approach presented in this study is applicable for measuring all six activities and for monitoring postoperative recovery of cardiac surgery patients. A next step is to provide feedback to patients and healthcare professionals, to speed up recovery.

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Controlling Nutritional Status (CONUT) score predicts worse outcomes in Chinese cardiac surgery patients

10.21203/rs.2.22932/v1 ◽

2020 ◽

Author(s):

Yan Yang ◽

Pei Zhang ◽

Hua Zhou ◽

Min Yang

Keyword(s):

Cardiac Surgery ◽

Postoperative Complications ◽

Nutritional Status ◽

Cox Regression ◽

Characteristic Curve ◽

Laboratory Data ◽

Prognostic Impact ◽

All Cause Mortality ◽

Secondary Outcomes ◽

Conut Score

Abstract Background & Aims: Nutritional and immunological status was assessed by the Controlling Nutritional Status (CONUT) score calculated from serum albumin, total cholesterol and total peripheral lymphocyte count. The aim of this study was to determine the prognostic impact of the CONUT score on patients underwent cardiac surgery.Methods: This is a single-center retrospective observational study in cardiac surgery patients. Baseline characteristics, comorbidities, and laboratory data were collected. The primary outcome was all-cause mortality. The secondary outcomes were postoperative complications including acute kidney injury (AKI), transient ischemic attack or stroke, reoperation for bleeding. Univariate and multivariate Cox regression were performed to investigate the association between confounding factors and outcomes. The cut-off value of CONUT score was accessed by the receiving operating characteristic curve. We used the Kaplan-Meier curve to compare the outcomes according to the cut-off CONUT score. The area under the curve (AUC) was used to test discriminative power of CONUT score and relevant clinical parameters. Results: A total of 408 patients were enrolled in this study. During a median follow-up period of 72.12 months, 28 (6.9%) patients died and 43 (10.5%) patients occurred postoperative complications. The rate of all-cause mortality and postoperative complications was higher in the high CONUT score (>3) group than in the low CONUT score group (p=0.002, p=0.02). High CONUT score (hazard ratio [HR] =2.367, 95% confidence interval [CI]=1.072 to 5.266, P=0.033) was an independent predictor of all-cause mortality. The AUC of the joint probability of CONUT score, age, and hypertension in predicting all-cause mortality was 0.744 (95% CI: 0.687–0.775). The high CONUT score was still an independent risk factor of secondary outcomes (HR=2.316, 95%CI=1.122 to 4.780, P=0.023).Conclusion: The CONUT score was independently associated with all-cause mortality and postoperative complications in patients underwent cardiac surgery.

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Analysis of the influence of risk factors on the development of complications after heart surgery

Medical Science And Education Of Ural ◽

10.36361/1814-8999-2021-22-2-111-114 ◽

2021 ◽

Vol 22 (2) ◽

pp. 111-114

Author(s):

V. V. Sokolova ◽

◽

V. E. Shneider ◽

T. E. Burova ◽

A. V. Dorovikova ◽

...

Keyword(s):

Risk Factors ◽

Cardiac Surgery ◽

Comparative Analysis ◽

Postoperative Complications ◽

Hospital Stay ◽

Heart Surgery ◽

Length Of Hospital Stay ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Surgery Department

Aim. To study the influence of risk factors on the development of complications in patients after heart surgery. Materials and methods. The study was carried out on the basis of the cardiac surgery department of the «OKB № 1», Tyumen. In the course of the work, a retrospective analysis of the results of cardiac surgery with sternotomy access was carried out on the basis of 469 case histories of patients in the period 2014-2020. Results. During the study, all patients were divided into 2 groups: patients with complications associated with access and without complications. As a result, a database of patients was created, on the basis of which a comparative analysis of 45 risk factors was carried out. Based on a comparative analysis, it was proved that in the development of postoperative complications, the leading risk factors among preoperative ones are diabetes mellitus, chronic obstructive pulmonary disease, obesity; among intraoperative risk factors, hemorrhage during surgery of more than 1000 ml is statistically significant. The number of resternotomies in history and the presence of risk factors affect the length of hospital stay and mortality after cardiac surgery. Conclusion. Timely diagnosis of concomitant diseases, their compensation and correction in the postoperative period affects and prevents the development of early postoperative complications. Careful hemostasis, a differentiated approach to osteosynthesis of the sternum after sternotomy reduce the risk of postoperative complications and the number of hospital stay days, which significantly reduces the economic costs of the hospital.

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Constitutions of Deficiency and Stasis of Traditional Chinese Medicine and Related Factors among Middle-Aged Women in Taiwan

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/7237029 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Ping-Ho Chen ◽

Sheng-Miauh Huang ◽

Jerry Cheng-Yen Lai ◽

Pei-Jung Yu

Keyword(s):

Logistic Regression ◽

Chinese Medicine ◽

Traditional Chinese Medicine ◽

Multiple Logistic Regression Analysis ◽

The Body ◽

Research Database ◽

Middle Aged ◽

Related Factors ◽

Yin Deficiency ◽

Younger Age

Background. Traditional Chinese medicine (TCM) appears to be the common therapy in middle-aged women. The constitution serves as a guide for TCM treatment. However, little is known about the constitution and related factors in middle-aged women. The objectives of this study were to describe the yang-deficiency, yin-deficiency, and stasis constitutions in middle-aged women. Demographic and health factors related to yang deficiency, yin deficiency, and stasis were also examined. Methods. A total of 1,000 women aged 40–65 years were selected from 2009 through 2018 using random sampling from the Taiwan Biobank Research Database in Taiwan. Yang-deficiency, yin-deficiency, and stasis were assessed using the body constitution questionnaire. Multiple logistic regression analysis was used to identify factors associated with constitution in deficiency or stasis. Results. The proportions of middle-aged women who had the constitution in yang-deficiency, yin-deficiency, and stasis were 29.7%, 21.7%, and 17.7%, respectively. The result of binary logistic regression showed that current menstruation, abnormal spirometry, and education level were predictive factors of yang deficiency. Women with younger age, abnormal spirometry, or a vegetarian diet had a significantly associated yin deficiency. Younger age, abnormal spirometry, and coffee habit were predictors of stasis. Conclusions. Middle-aged women in Taiwan with abnormal spirometry had a higher risk for deficiency or stasis constitutions, especially for those younger than 56 years. Healthcare providers should learn patients’ constitutions and provide appropriate advice, referring them to safe providers of their desired method.

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P2761Assessment of perioperative mortality risk in patients with infective endocarditis undergoing cardiac surgery: performance of the EuroSCORE II, PALSUSE, STS risk score for IE and modified AEPEI score

European Heart Journal ◽

10.1093/eurheartj/ehz748.1078 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

C Brizido ◽

S Madeira ◽

P Oliveira ◽

C Silva ◽

F F Gama ◽

...

Keyword(s):

Cardiac Surgery ◽

Infective Endocarditis ◽

Risk Score ◽

Heart Surgery ◽

Characteristic Curve ◽

Population Heterogeneity ◽

Risk Scores ◽

Perioperative Mortality ◽

Active Infective Endocarditis ◽

Lemeshow Test

Abstract Introduction and aim Infective endocarditis (IE) is a complex and heterogeneous disease which might lead to cardiac surgery. For such cases, several perioperative risk predictive tools have emerged. We aimed to validate the recently developed PALSUSE, STS risk score for IE and modified AEPEI score and to compare their performances with the established EuroSCORE II. Methods We retrospectively accessed 128 patients from a single center registry who underwent heart surgery for active infective endocarditis between January 2007 and November 2014. Discrimination and calibration of models were assessed by receiver operating characteristic curve analysis and Hosmer-Lemeshow test. Results Perioperative mortality was 16.4% (n=21). The median EuroSCORE II, PALSUSE, STS risk score for IE and modified AEPEI score were 6.6% [IQR 3.5–18.2], 5 [IQR 3–7], 25 [IQR 16–32] and 1 [IQR 0–1.8], respectively. Discriminative power was numerically higher for EuroSCORE II (AUC of 0.83, 95% CI, 0.75–0.91) followed by STS risk score for IE (AUC of 0.75, 95% CI 0.64–0.86), PALSUSE (AUC of 0.74, 95% CI 0.64–0.86) and modified AEPEI (AUC of 0.68, 95% CI 0.57–0.788) – figure 1. The Hosmer-Lemeshow test showed good calibration for EuroSCORE II (p=0.08) and STS risk score for IE (p=0.03) but not for PALSUSE (p=0.65), modified AEPEI (p=0.12). Figure 1 Conclusion All scores adequately stratified peri-operative risk in active infective endocarditis, however EuroSCORE II in the overall comparison performed better in this population. Heterogeneity of performance of risk scores in different cohorts of infective endocarditis highlights the complexity of this disease.

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