Background

Functional limitation is relatively common and can negatively influence the postoperative outcome of patients after cardiac surgery.

Objective

To identify the predictive factors of functional limitation in patients undergoing elective cardiac surgery.

Methods

Retrospective cohort study was performed to evaluate patients undergoing elective cardiac surgery. All patients underwent a cardiovascular rehabilitation protocol. Functional limitation was defined based on performance in the rehabilitation protocol following cardiac surgery. Poor performance in the cardiac surgery rehabilitation protocol defined functional limitation, whereas good performance indicated no limitation.

Results

Data were collected from 548 patients; of these, 190 (34.7%) had functional limitation. In multivariate analysis, the factors associated with postoperative functional limitation were as follows: hospitalization by the public healthcare system [OR: 2.14; 95% confidence interval (CI): 1.73, 2.65]; age (OR 1.23; 95% CI: 1.15, 1.31); length of hospitalization in the intensive care unit (OR 1.03; 95% CI: 1.01, 1.05); history of previous acute myocardial infarction (OR 1.40; 95% CI: 1.13, 1.73); presence of previous comorbidities [chronic kidney disease (OR 1.56; 95% CI: 1.15, 2.10); cerebrovascular disease (OR 1.57; 95% CI: 1.19, 2.07)]; presence of expiratory muscle weakness (OR 1.54; 95% CI: 1.08, 2.20); and intercurrence of cardiorespiratory arrest during hospitalization (OR 1.76; 95% CI: 1.40, 2.22).

Conclusion

Functional limitation after cardiac surgery could be predicted by multiple pre and postoperative factors, except for preoperative functionality, which does not suggest to be an independent factor for functional limitation after surgery.

中文翻译：

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心脏手术后功能受限的预测因素：回顾性队列研究

背景

功能限制相对常见，会对心脏手术后患者的术后结果产生负面影响。

客观的

确定接受择期心脏手术的患者功能受限的预测因素。

方法

进行回顾性队列研究以评估接受择期心脏手术的患者。所有患者均接受了心血管康复方案。功能限制是根据心脏手术后康复方案的表现来定义的。心脏手术康复方案中的不良表现定义了功能限制，而良好的表现表明没有限制。

结果

数据收集自 548 名患者；其中，190 人（34.7%）存在功能限制。多因素分析显示，与术后功能受限相关的因素如下：公共医疗系统住院[OR：2.14；OR：2.14；OR：2.14]。95%置信区间（CI）：1.73，2.65]；年龄（OR 1.23；95% CI：1.15，1.31）；重症监护室住院时间（OR 1.03；95% CI：1.01，1.05）；既往有急性心肌梗塞病史（OR 1.40；95% CI：1.13，1.73）；既往存在合并症[慢性肾脏病（OR 1.56；95% CI：1.15，2.10）；脑血管疾病（OR 1.57；95% CI：1.19，2.07）]；存在呼气肌无力（OR 1.54；95% CI：1.08，2.20）；住院期间反复发生心肺骤停（OR 1.76；95% CI：1.40，2.22）。

结论

心脏手术后的功能限制可以通过多种术前和术后因素来预测，但术前功能除外，这并不表明是术后功能限制的独立因素。