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术前简易体能测试作为老年患者冠状动脉旁路移植术后延长住院时间的预测指标。

Preoperative Short Physical Performance Battery as a predictor of prolonged hospitalization after coronary artery bypass grafting in older patients.

机构信息

Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.

TEDA International Cardiovascular Hospital, Tianjin, China.

出版信息

J Int Med Res. 2021 Sep;49(9):3000605211044043. doi: 10.1177/03000605211044043.

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.

摘要

目的

本研究旨在评估简易体能状况量表(SPPB)及其三个分量表对预测冠状动脉旁路移植术(CABG)老年患者住院时间延长的价值。

方法

这是一项前瞻性、观察性研究,纳入了 425 名连续接受选择性 CABG 手术的老年患者。所有患者均接受 SPPB 评估。我们分析了术后住院时间与 SPPB 及三个分量表之间的相关性。采用受试者工作特征曲线分析来确定 SPPB 预测住院时间延长(>8 天)的有效性。

结果

SPPB 及其三个分量表均为术后住院时间延长的独立危险因素。只有 SPPB 总分和 4 米步速分量表具有良好的判别能力。SPPB 评分<9.5 时,预测住院时间延长的准确性最佳。术后体能较差(SPPB<10 分)与出院后 6 个月内心血管不良事件风险增加相关。

结论

本研究为 SPPB 评分用于识别 CABG 术后住院时间延长风险较高的老年患者提供了临床依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6284/8451264/d221090a10f2/10.1177_03000605211044043-fig1.jpg

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