Ashikaga Kohei, Saji Mike, Takanashi Shuichiro, Nagayama Masatoshi, Akashi Yoshihiro J, Isobe Mitsuaki
Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu, 183-0003, Tokyo, Japan.
Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan.
Heart Vessels. 2019 Oct;34(10):1665-1673. doi: 10.1007/s00380-019-01397-y. Epub 2019 Apr 10.
The usefulness of performing physical function assessments for evaluating clinical outcomes after all cardiac surgeries has been reported. However, no studies have evaluated the relationship between physical function and prognosis in patients undergoing cardiac open surgery with mitral valve regurgitation (MR). This study investigated whether physical assessment, such as the short physical performance battery (SPPB), could predict unplanned readmission events in patients undergoing mitral valve surgery due to MR. SPPB could predict unplanned admission events in patients undergoing mitral valve surgery due to MR. This retrospective study included 168 patients who underwent mitral valve surgery. SPPB was performed 1.6 ± 1.1 days before surgery. The primary endpoint was unplanned readmission. The mean follow-up period was 762 ± 480 days, mean age was 73.8 ± 6.3 years, and 43% of the patients were women. Of the study patients, 46 required unplanned readmissions; 29 of these patients required readmissions within 1 year. Multivariate Cox regression analysis demonstrated that SPPB was independently associated with the primary endpoint. Receiver-operating characteristic analysis showed that SPPB had an area under the curve of 0.71, with an optimal cutoff of 11. The study patients were stratified into SPPB 12 or SPPB ≤ 11 groups. Kaplan-Meier analysis showed that the event-free rate was significantly lower in the SPPB ≤ 11 group (hazard ratio 3.8, 95% confidence interval 2.1-7.0; p < 0.001). SPPB was a useful tool for predicting unplanned readmission in patients undergoing mitral valve surgery due to MR.
已有报道称，进行身体功能评估对评估所有心脏手术后的临床结局具有实用性。然而，尚无研究评估二尖瓣反流（MR）心脏直视手术患者的身体功能与预后之间的关系。本研究调查了诸如简短体能状况量表（SPPB）等身体评估能否预测因MR接受二尖瓣手术患者的非计划再入院事件。SPPB能够预测因MR接受二尖瓣手术患者的非计划入院事件。这项回顾性研究纳入了168例行二尖瓣手术的患者。术前1.6±1.1天进行SPPB评估。主要终点为非计划再入院。平均随访期为762±480天，平均年龄为73.8±6.3岁，43%的患者为女性。在研究患者中，46例需要非计划再入院；其中29例患者在1年内需要再入院。多因素Cox回归分析表明，SPPB与主要终点独立相关。受试者工作特征分析显示，SPPB的曲线下面积为0.71，最佳截断值为11。研究患者被分为SPPB 12或SPPB≤11组。Kaplan-Meier分析显示，SPPB≤11组的无事件发生率显著更低（风险比3.8，95%置信区间2.1 - 7.0；p < 0.001）。SPPB是预测因MR接受二尖瓣手术患者非计划再入院的有用工具。
