1
|
Kurexi A, Yan R, Yuan T, Taati Z, Mijiti M, Li D. Development of a predictive model for postoperative major adverse cardiovascular events in elderly patients undergoing major abdominal surgery. BMC Surg 2024; 24:403. [PMID: 39709364 DOI: 10.1186/s12893-024-02711-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 12/09/2024] [Indexed: 12/23/2024] Open
Abstract
OBJECTIVE To investigate the predictive value of a Short Physical Performance Battery (SPPB) for postoperative major adverse cardiovascular events(MACEs) in elderly patients undergoing major abdominal surgery and to develop a nomogram risk prediction model. METHODS A total of 427 elderly patients aged ≥ 65 years who underwent major abdominal surgery at our hospital between June 2023 and March 2024 were selected for the study, and 416 patients were ultimately included. The preoperative SPPB score was measured, and the patients were divided into two groups: a high SPPB group (≥ 10) and a low SPPB group (< 10). The subjects' clinical datasets and postoperative major adverse cardiovascular event (MACEs) occurrence data were recorded. LASSO regression analysis was performed to screen predictor variables and develop a nomogram risk prediction model for predicting MACEs. The area under the receiver operating characteristic (ROC) curve (AUC), calibration curve, and decision curve analysis (DCA) were used to evaluate the model's clinical efficacy. RESULTS The incidence of postoperative MACEs in elderly patients who underwent major abdominal surgery was 5%. LASSO regression analysis revealed that arrhythmia, creatine kinase, SPPB, anesthesia duration, age, intraoperative minimum heart rate, BMI, and coronary artery disease were significant predictors of MACEs. The nomogram risk prediction model based on SPPB and clinical indicators can better predict the occurrence of MACEs and can guide preoperative interventions and help to improve perioperative management.The decision curve indicated encouraging clinical effectiveness, the calibration curve demonstrated good agreement, and the area under the curve (AUC) was 0.852 (95% CI, 0.749-0.954). CONCLUSION The nomogram risk prediction model based on SPPB and clinical indicators can better predict the occurrence of MACEs and can guide preoperative intervention and help to improve perioperative management.
Collapse
Affiliation(s)
- Adilai Kurexi
- The 3rd Affiliated Teaching Hospital of Xinjiang Medical University (Affiliated Cancer Hospital), Urumqi, China
| | - Rui Yan
- The 3rd Affiliated Teaching Hospital of Xinjiang Medical University (Affiliated Cancer Hospital), Urumqi, China.
| | - Tingting Yuan
- The 3rd Affiliated Teaching Hospital of Xinjiang Medical University (Affiliated Cancer Hospital), Urumqi, China
| | - Zhaenhaer Taati
- The 3rd Affiliated Teaching Hospital of Xinjiang Medical University (Affiliated Cancer Hospital), Urumqi, China
| | - Maimaiti Mijiti
- The 3rd Affiliated Teaching Hospital of Xinjiang Medical University (Affiliated Cancer Hospital), Urumqi, China
| | - Dan Li
- The 3rd Affiliated Teaching Hospital of Xinjiang Medical University (Affiliated Cancer Hospital), Urumqi, China
| |
Collapse
|
2
|
Kappenschneider T, Bammert P, Maderbacher G, Greimel F, Holzapfel DE, Schwarz T, Götz J, Pagano S, Scharf M, Michalk K, Grifka J, Meyer M. The impact of elective total hip and knee arthroplasty on physical performance in orthogeriatric patients: a prospective intervention study. BMC Geriatr 2023; 23:763. [PMID: 37990164 PMCID: PMC10664286 DOI: 10.1186/s12877-023-04460-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 11/06/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Osteoarthritis is a prevalent condition in older adults that leads to reduced physical function in many patients and ultimately requires hip or knee replacement. The aim of the study was to determine the impact of hip and knee arthroplasty on the physical performance of orthogeriatric patients with osteoarthritis. METHODS In this prospective study, we used data from 135 participants of the ongoing Special Orthopaedic Geriatrics (SOG) trial, funded by the German Federal Joint Committee (GBA). Physical function, measured by the Short Physical Performance Battery (SPPB), was assessed preoperatively, 3 and 7 days postoperatively, 4-6 weeks and 3 months after hip and knee arthroplasty. For the statistical analysis, the Friedman test and post-hoc tests were used. RESULTS Of the 135 participants with a mean age of 78.5 ± 4.6 years, 81 underwent total hip arthroplasty and 54 total knee arthroplasty. In the total population, SPPB improved by a median of 2 points 3 months after joint replacement (p < 0.001). In the hip replacement group, SPPB increased by a median of 2 points 3 months after surgery (p < 0.001). At 3 months postoperatively, the SPPB increased by a median of 1 point in the knee replacement group (p = 0.003). CONCLUSION Elective total hip and knee arthroplasty leads to a clinically meaningful improvement in physical performance in orthogeriatric patients with osteoarthritis after only a few weeks. TRIAL REGISTRATION This study is part of the Special Orthopaedic Geriatrics (SOG) trial, German Clinical Trials Register DRKS00024102. Registered on 19 January 2021.
Collapse
Affiliation(s)
- Tobias Kappenschneider
- Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany.
| | - Philip Bammert
- Department of Health Economics, Technical University of Munich, Munich, Germany
| | - Günther Maderbacher
- Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Felix Greimel
- Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | | | - Timo Schwarz
- Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Julia Götz
- Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Stefano Pagano
- Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Markus Scharf
- Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Katrin Michalk
- Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Joachim Grifka
- Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| | - Matthias Meyer
- Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany
| |
Collapse
|
3
|
Hansen C, Chebil B, Cockroft J, Bianchini E, Romijnders R, Maetzler W. Changes in Coordination and Its Variability with an Increase in Functional Performance of the Lower Extremities. BIOSENSORS 2023; 13:156. [PMID: 36831922 PMCID: PMC9953305 DOI: 10.3390/bios13020156] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Clinical gait analysis has a long-standing tradition in biomechanics. However, the use of kinematic data or segment coordination has not been reported based on wearable sensors in "real-life" environments. In this work, the skeletal kinematics of 21 healthy and 24 neurogeriatric participants was collected in a magnetically disturbed environment with inertial measurement units (IMUs) using an accelerometer-based functional calibration method. The system consists of seven IMUs attached to the lower back, the thighs, the shanks, and the feet to acquire and process the raw sensor data. The Short Physical Performance Battery (SPPB) test was performed to relate joint kinematics and segment coordination to the overall SPPB score. Participants were then divided into three subgroups based on low (0-6), moderate (7-9), or high (10-12) SPPB scores. The main finding of this study is that most IMU-based parameters significantly correlated with the SPPB score and the parameters significantly differed between the SPPB subgroups. Lower limb range of motion and joint segment coordination correlated positively with the SPPB score, and the segment coordination variability correlated negatively. The results suggest that segment coordination impairments become more pronounced with a decreasing SPPB score, indicating that participants with low overall SPPB scores produce a peculiar inconsistent walking pattern to counteract lower extremity impairment in strength, balance, and mobility. Our findings confirm the usefulness of SPPB through objectively measured parameters, which may be relevant for the design of future studies and clinical routines.
Collapse
Affiliation(s)
- Clint Hansen
- Neurogeriatrics, University Hospital Kiel, 24105 Kiel, Germany
| | - Baraah Chebil
- Neurogeriatrics, University Hospital Kiel, 24105 Kiel, Germany
| | - John Cockroft
- Neuromechanics Unit, Stellenbosch University, Stellenbosch 7602, South Africa
| | | | - Robbin Romijnders
- Neurogeriatrics, University Hospital Kiel, 24105 Kiel, Germany
- Digital Signal Processing and System Theory, Kiel University, 24118 Kiel, Germany
| | - Walter Maetzler
- Neurogeriatrics, University Hospital Kiel, 24105 Kiel, Germany
| |
Collapse
|
4
|
Valente CJ, Chiuzan C, Alreshq R, Blot T, Fine D, Helmke S, Rodriguez C, Sabogal N, Teruya S, Winburn M, Kurian D, Raiszadeh F, Maurer MS, Ruberg FL. Physical Performance in Black and Hispanic Outpatients with Heart Failure: The SCAN-MP Study. CJC Open 2022; 5:292-302. [PMID: 37124967 PMCID: PMC10140745 DOI: 10.1016/j.cjco.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
Background Deficits of physical function are associated with poor quality of life and adverse health outcomes, but data informing the association of these assessments among Black and Hispanic outpatients with heart failure (HF) are limited. Methods The multicentre, prospective Screening for Cardiac Amyloidosis With Nuclear Imaging for Minority Populations (SCAN-MP) study identified Black and Hispanic subjects with stable HF, collected baseline characteristics, and took measures using the short physical performance battery. Subjects completed a Kansas City Cardiomyopathy Questionnaire (KCCQ), and the clinical outcomes of HF hospitalization and death were ascertained by telephone and review of the electronic health record. Results Of 320 participants, 227 (70.9%) had physical deficits, defined by a battery score of ≤ 9. Patients with severe physical deficits reported overall lower KCCQ scores compared to those with no deficits (KCCQ score of 57.0 vs 72.4, P < 0.001). Physical limitation was significantly associated with risk of HF hospitalization, after adjustments for age, sex, and New York Heart Association class (severe physical deficit hazard ratio, 3.61; 95% confidence interval [CI], 1.19-10.93; P = 0.024; mild physical deficit hazard ratio, 2.59; 95% CI, 0.86-7.75; P = 0.090). Conclusions Reduced physical performance is highly prevalent among Black and Hispanic outpatients with HF, and it is associated with overall KCCQ score, as well as an increased risk for HF hospitalization.
Collapse
|
5
|
Iwatsu K, Ikeda T, Matsumura K, Ashikawa H, Fujita R, Takabayashi K, Kitaguchi S, Nohara R. Gap in the prognostic impact of short physical performance battery among phenotypes of heart failure. Int J Cardiol 2022; 361:85-90. [DOI: 10.1016/j.ijcard.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 03/25/2022] [Accepted: 05/02/2022] [Indexed: 11/30/2022]
|
6
|
Han P, Yu H, Zhang Y, Xie F, Shao B, Liu X, Yuan B, Liu Z, Liu X, Guo Q. Preoperative Short Physical Performance Battery as a predictor of prolonged hospitalization after coronary artery bypass grafting in older patients. J Int Med Res 2021; 49:3000605211044043. [PMID: 34528470 PMCID: PMC8451264 DOI: 10.1177/03000605211044043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective The study aimed to evaluate the predictive value of the Short Physical Performance Battery (SPPB) and its three components for identifying the requirement for a prolonged hospitalization for coronary artery bypass grafting (CABG) in older patients. Methods This prospective, observational study included 425 older patients who consecutively underwent selective CABG surgery. All patients were assessed for the SPPB. We analysed the association of the postoperative length of hospital stay with the SPPB and three components. Receiver operating characteristic curve analysis was performed to determine the validity of the SPPB for predicting older patients with a prolonged hospitalization (>8 days). Results The SPPB and its three individual components were independent risk factors for a prolonged postoperative length of hospital stay. Only the SPPB summary score and the 4-m gait speed components showed good discriminative capabilities. An SPPB score cut-off of 9.5 provided the best accuracy for identifying a prolonged hospitalization. A poor physical performance (SPPB <10 score) was related to an increased risk of adverse cardiac and cerebrovascular events within 6 months after discharge. Conclusions This study provides evidence for clinical utility of the SPPB score for identifying older patients undergoing CABG who are at risk of prolonged hospitalization.
Collapse
Affiliation(s)
- Peipei Han
- Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.,TEDA International Cardiovascular Hospital, Tianjin, China
| | - Hairui Yu
- Wuhan University Zhongnan Hospital, Wuhan, Hubei, China
| | - Yuanyuan Zhang
- TEDA International Cardiovascular Hospital, Tianjin, China
| | - Fandi Xie
- Shanghai Jiangwan Hospital, Shanghai, China
| | - Bohan Shao
- TEDA International Cardiovascular Hospital, Tianjin, China
| | - Xiangjing Liu
- TEDA International Cardiovascular Hospital, Tianjin, China
| | - Bo Yuan
- TEDA International Cardiovascular Hospital, Tianjin, China
| | - Zhigang Liu
- TEDA International Cardiovascular Hospital, Tianjin, China
| | - Xiaocheng Liu
- TEDA International Cardiovascular Hospital, Tianjin, China
| | - Qi Guo
- Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.,TEDA International Cardiovascular Hospital, Tianjin, China
| |
Collapse
|
7
|
Przkora R, Sibille K, Victor S, Meroney M, Leeuwenburgh C, Gardner A, Vasilopoulos T, Parvataneni HK. Blood flow restriction exercise to attenuate postoperative loss of function after total knee replacement: a randomized pilot study. Eur J Transl Myol 2021; 31. [PMID: 34459574 PMCID: PMC8495367 DOI: 10.4081/ejtm.2021.9932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/16/2021] [Indexed: 11/22/2022] Open
Abstract
Aging well is directly associated with a healthy lifestyle. The focus of this paper is to relate that attenuation of postoperative loss of muscle function after a total knee arthroplasty (TKA) is an important consideration. Because patients usually do not tolerate standard high-resistance exercise in the preoperative or postoperative period, they often experience a decline in strength and function. Therefore, we tested the feasibility and acceptability of an alternative low-resistance exercise protocol with blood flow restriction (BFR) using a tourniquet in the preoperative period for patients awaiting TKA. We recruited patients undergoing a TKA and randomized six to the BFR exercise for 4 weeks prior to surgery and four to standard of care (no exercise). We measured physical function using the Short Physical Performance Battery (SPPB), the 6-Minute Walk Test (6MWT), leg strength (peak torque), and pain (numerical pain score) 4 to 5 weeks preoperatively and 2 weeks postoperatively. The clinical management, e.g., anesthetic management, did not differ between groups. No complications were observed. Our findings demonstrate the feasibility and acceptability of the BFR intervention. Although preliminary and not powered for comparison, the BFR group demonstrated less decline in SPPB following surgery (−2.2, 95%CI:−4.4,0.1) compared to the no exercise group (−4.8, 95%CI:−7.8,−1.7). No differences were noted for the 6MWT, leg strength, and pain measurements. We conclude that preoperative low-resistance exercise using the BFR is feasible and acceptable, and this test warrants investigation as an intervention to potentially attenuate the postoperative loss of physical function after TKA.
Collapse
Affiliation(s)
- Rene Przkora
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida.
| | - Kimberly Sibille
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA; Department of Aging and Geriatric Research, University of Florida College of Medicine, Gainesville, Florida.
| | - Sandra Victor
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida.
| | - Matthew Meroney
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida.
| | - Christiaan Leeuwenburgh
- Department of Aging and Geriatric Research, University of Florida College of Medicine, Gainesville, Florida, USA; Department of Anatomy and Cell Biology, University of Florida College of Medicine, Gainesville, Florida.
| | - Anna Gardner
- Department of Applied Physiology and Kinesiology, University of Florida College of Health and Human Performance, Gainesville, Florida.
| | - Terrie Vasilopoulos
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA; Department of Orthopaedics and Rehabilitation, University of Florida College of Medicine, Gainesville, Florida.
| | - Hari K Parvataneni
- Department of Orthopaedics and Rehabilitation, University of Florida College of Medicine, Gainesville, Florida.
| |
Collapse
|
8
|
Giacchi M, Nguyen MT, Gaudin J, Bergin M, Collicoat O, Armstrong B, Jennings S, El-ansary D, Lee AL. The relationship between cardiorespiratory parameters, mobilisation and physical function following cardiac surgery. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2021. [DOI: 10.1080/21679169.2021.1942195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Matthew Giacchi
- Department of Medicine, Monash University, Clayton, Australia
| | - My-Thao Nguyen
- Department of Medicine, Monash University, Clayton, Australia
| | - James Gaudin
- Centre for Allied Health Research and Education, Cabrini Health, Malvern, Australia
| | - Miles Bergin
- Centre for Allied Health Research and Education, Cabrini Health, Malvern, Australia
| | - Olivia Collicoat
- Centre for Allied Health Research and Education, Cabrini Health, Malvern, Australia
| | - Bronte Armstrong
- Centre for Allied Health Research and Education, Cabrini Health, Malvern, Australia
| | - Sophie Jennings
- Centre for Allied Health Research and Education, Cabrini Health, Malvern, Australia
| | - Doa El-ansary
- Physiotherapy, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Australia
- Department of Surgery, Royal Melbourne Hospital, School of Medicine, University of Melbourne, Parkville, Australia
| | - Annemarie L. Lee
- Centre for Allied Health Research and Education, Cabrini Health, Malvern, Australia
- Department of Physiotherapy, Monash University, Frankston, Australia
| |
Collapse
|
9
|
Penati C, Incorvaia C, Mollo V, Lietti F, Gatto G, Stefanelli M, Centeleghe P, Talarico G, Mori I, Franzelli C, Ratti F, Ponticelli MP, Ridolo E, Febo OC. Cardiac rehabilitation outcome after transcatheter aortic valve implantation. Monaldi Arch Chest Dis 2021; 91. [PMID: 33849260 DOI: 10.4081/monaldi.2021.1621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/02/2020] [Indexed: 11/23/2022] Open
Abstract
Patients with severe aortic stenosis are increasingly treated with transcatheter aortic valve implantation (TAVI) as a safer option to surgical aortic valve replacement (sAVR). Similar to many other heart diseases, after the specific therapeutic intervention patients are eligible for cardiac rehabilitation (CR) for the purpose of functional recovery. Thus far, CR after both sAVR and TAVI has been used to a limited extent, as shown by the availability of only two meta-analyses including 5 studies and 6 studies, respectively. Recent observational studies reported a significant improvement in functional indexes such as the Barthel scale and the 6-minute walk test (6MWT). We evaluated the outcome of CR in patients after TAVI treatment by measuring changes in the commonly used Barthel scale and 6MWT and adding the short physical performance battery (SPPB) scale as an index to assess lower extremity function. All indexes demonstrated a significant improvement, namely p<0.001 with the Barthel scale, p=0.043 for the 6MWT, and p=0.002 for SPPB. These results confirm the significant improvement of the Barthel scale and 6MWT reported in the previous meta-analysis and suggest the utility of SPPB as a further index of efficacy of CR in patients with severe aortic stenosis treated with TAVI.
Collapse
Affiliation(s)
- Chiara Penati
- Cardiac/Pulmonary Rehabilitation, ASST Pini-CTO, Milan.
| | | | | | | | - Gemma Gatto
- Cardiac/Pulmonary Rehabilitation, ASST Pini-CTO, Milan.
| | | | | | | | - Ileana Mori
- Cardiac/Pulmonary Rehabilitation, ASST Pini-CTO, Milan.
| | | | - Fosco Ratti
- Cardiac/Pulmonary Rehabilitation, ASST Pini-CTO, Milan.
| | | | - Ermina Ridolo
- Allergy and Clinical Immunology, Medicine and Surgery Department, University of Parma.
| | | |
Collapse
|
10
|
Przkora R, Sibille K, Victor S, Meroney M, Leeuwenburgh C, Gardner A, Vasilopoulos T, Parvataneni HK. Assessing the feasibility of using the short physical performance battery to measure function in the immediate postoperative period after total knee replacement. Eur J Transl Myol 2021; 31. [PMID: 33840178 PMCID: PMC8274223 DOI: 10.4081/ejtm.2021.9673] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/01/2021] [Indexed: 12/27/2022] Open
Abstract
Measurements of physical function after total knee arthroplasty (TKA) are uncertain and require investments for special equipment, space, and staff. Therefore, we evaluated the Short Physical Performance Battery (SPPB) 4 to 6 weeks preoperatively and 2 weeks following TKA as this test battery addresses lower extremity strength, coordination, and balance, without additional special investments. For context, we also employed the Six-Minute Walk test (6MWT) and peak torque knee extension. Our analysis consisted of three women and one man, with average ages of 68.3±3.9 years. Patients showed a decrease in all functional measurements: SPPB (mean change: -4.8±1.9, 44% decrease), 6MWT (-0.37±.21 m/s, 34% decrease), and peak torque (-11.8±8.8°/s, 68% decrease). Our findings suggest the SPPB is feasible and can be integrated easily in daily clinical practice.
Collapse
Affiliation(s)
- Rene Przkora
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida.
| | - Kimberly Sibille
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida; Department of Aging and Geriatric Research, University of Florida College of Medicine, Gainesville, Florida.
| | - Sandra Victor
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida.
| | - Matthew Meroney
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida.
| | - Christiaan Leeuwenburgh
- Department of Aging and Geriatric Research, University of Florida College of Medicine, Gainesville, Florida; Department of Anatomy and Cell Biology, University of Florida College of Medicine, Gainesville, Florida.
| | - Anna Gardner
- Department of Applied Physiology and Kinesiology, University of Florida College of Health and Human Performance, Gainesville, Florida.
| | | | - Hari K Parvataneni
- Department of Orthopaedics and Rehabilitation, University of Florida College of Medicine, Gainesville, Florida.
| |
Collapse
|
11
|
Ashikaga K, Doi S, Yoneyama K, Watanabe M, Suzuki N, Kuwata S, Kaihara T, Koga M, Okuyama K, Kamijima R, Tanabe Y, Takeichi N, Watanabe S, Izumo M, Kida K, Akashi YJ. Impact of perioperative change in physical function on midterm outcomes after transcatheter aortic valve implantation. Heart Vessels 2021; 36:1072-1079. [PMID: 33484292 DOI: 10.1007/s00380-021-01776-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/08/2021] [Indexed: 11/26/2022]
Abstract
Preoperative frailty diminishes the potential for functional recovery after transcatheter aortic valve implantation (TAVI). However, perioperative changes in physical status and their impact on prognosis after TAVI have not previously been reported. Therefore, this study aimed to investigate whether perioperative changes in physical function affect prognosis in patients undergoing TAVI. We retrospectively reviewed 257 patients who underwent TAVI. The Short Physical Performance Battery (SPPB), an objective physical status assessment tool, was evaluated pre- and post-TAVI. Patients were divided into two groups: (i) patients whose SPPB score declined in the perioperative period (the decline group) and (ii) patients whose SPPB score did not decline in the perioperative period (the non-decline group). The primary endpoint was unplanned hospitalization owing to heart failure or cardiovascular death following TAVI. The mean follow-up period was 385 ± 151 days, mean age was 83.2 ± 5.8 years, and 67% of the patients were women. Sixteen patients required readmission owing to heart failure, and seven experienced cardiovascular-related death. Kaplan-Meier analysis revealed that the event-free rate was significantly lower in the decline group (log-rank, p = 0.006). A stepwise multivariate logistic regression analysis showed that a perioperative change in SPPB was significantly associated with primary endpoints (odds ratio, 1.51; 95% confidence interval, 1.12-2.04). Perioperative change in physical function was an independent risk factor for heart failure, hospitalization, or cardiovascular death following TAVI.
Collapse
Affiliation(s)
- Kohei Ashikaga
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.
| | - Shunichi Doi
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Kihei Yoneyama
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Mika Watanabe
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Norio Suzuki
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Shingo Kuwata
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Toshiki Kaihara
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Masashi Koga
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Kazuaki Okuyama
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Ryo Kamijima
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Yasuhiro Tanabe
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Naoya Takeichi
- Rehabilitation Center, St. Marianna University School of Medicine Hospital, Kawasaki, Japan
| | - Satoshi Watanabe
- Rehabilitation Center, St. Marianna University School of Medicine Hospital, Kawasaki, Japan
| | - Masaki Izumo
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Keisuke Kida
- Department of Pharmacology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yoshihiro J Akashi
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| |
Collapse
|