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体力活动减少是心脏手术后恢复复杂的一个预测指标。

Decreased physical activity is a predictor for a complicated recovery post cardiac surgery.

作者信息

van Laar Charlotte, TImman Simone T, Noyez Luc

机构信息

Department of Cardio-Thoracic Surgery - 615, Heart Center, Radboud University Nijmegen Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands.

出版信息

Health Qual Life Outcomes. 2017 Jan 7;15(1):5. doi: 10.1186/s12955-016-0576-6.

Abstract

BACKGROUND

Physical activity (PA) reduces the risk of cardiovascular disease and physically active survivors of a cardiac event are at lower risk of recurrent events. We hypothesized that patients with a decreased PA, undergoing cardiac surgery, are at higher risk for a postoperative complicated recovery (PCR).

METHODS

Three thousand three hundred eighty two patients undergoing elective cardiac surgery between January 2007 and December 2013 were included. The group was divided into three subgroups: group A, aged ≤ 65 years (N = 1329); group B, aged > 65 years and ≤ 75 years (N = 1250); and group C aged >75 years (N = 803). To assess PA, the criteria of the Corpus Christy Heart Project were used. A PCR consists of the occurrence of a major postoperative event, defined as any of the following complications: reoperation, deep sternal wound infection, renal failure, stroke, postoperative ventilation > 2 days, intensive care stay ≥ 5 days, hospital stay ≥ 10 days, or hospital mortality.

RESULTS

One thousand three hundred sixty seven patients (40%) were considered as patients with a decreased PA. Both in group B (p = 0.001) and in group C (p = 0.003), patients with a decreased PA were significantly associated with an increased risk of a PCR, which was not the case in group A (p = 0.28). Logistic regression analysis identified a decreased PA as an independent predictor for PCR in groups B (p = 0.003, odds 1.71) and C (p = 0.033, odds 1.48), but not in group A (p = 0.11, odds 0.71).

CONCLUSION

Decreased physical activity is an independent predictor for a PCR in patients aged 65 years or older undergoing elective cardiac surgery.

摘要

背景

身体活动(PA)可降低心血管疾病风险,心脏事件后身体活动的幸存者再次发生事件的风险较低。我们假设,接受心脏手术且身体活动减少的患者术后发生复杂恢复(PCR)的风险更高。

方法

纳入2007年1月至2013年12月期间接受择期心脏手术的3382例患者。该组分为三个亚组:A组,年龄≤65岁(N = 1329);B组,年龄>65岁且≤75岁(N = 1250);C组,年龄>75岁(N = 803)。采用科珀斯克里斯蒂心脏项目的标准评估身体活动。PCR包括术后发生的主要事件,定义为以下任何一种并发症:再次手术、深部胸骨伤口感染、肾衰竭、中风、术后通气>2天、重症监护病房停留≥5天、住院时间≥10天或医院死亡率。

结果

1367例患者(40%)被认为是身体活动减少的患者。在B组(p = 0.001)和C组(p = 0.003)中,身体活动减少的患者与PCR风险增加显著相关,A组则不然(p = 0.28)。逻辑回归分析确定,身体活动减少是B组(p = 0.003,比值1.71)和C组(p = 0.033,比值1.48)中PCR的独立预测因素,但在A组中不是(p = 0.11,比值0.71)。

结论

身体活动减少是65岁及以上接受择期心脏手术患者发生PCR的独立预测因素。

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