Department of Physiotherapy, James Cook University, Townsville, Queensland, Australia.
Australian Institute of Tropical Health & Medicine, James Cook University, Townsville, Queensland, Australia.
PLoS One. 2022 Feb 23;17(2):e0263683. doi: 10.1371/journal.pone.0263683. eCollection 2022.
Handgrip strength (HGS), lung function and health-related quality of life (HRQoL) are relevant indicators of future cardiovascular risk and mortality. The impact of cardiac surgery on these predictive variables has been under-explored. The aim of this study was to determine the acute (within hospital) changes in HGS, lung function and HRQoL, and their relationships, in adults undergoing elective cardiac surgery. Further, the study examined the relationship between these variables and the predictors for lung function and HRQoL in these patients.
The study was a prospective cohort study that involved 101 patients who completed pre-operative (1-2 days before surgery) and physiotherapy discharge (5-7 days after surgery) assessments. Handgrip strength, lung function and HRQoL were assessed using JAMAR dynamometers, Vitalograph-Alpha or EasyOne spirometer, and Short-Form 36 questionnaire, respectively. Changes in these variables and their relationships were analysed using paired t-test and Pearson correlation coefficients, respectively. Prediction of lung function and HRQoL using HGS and other co-variates was conducted using regression analysis.
At the time of physiotherapy discharge, lung function, HGS and the physical component of HRQoL were significantly (<0.001) reduced compared to their pre-operative values. Significant (<0.001) and moderate correlations were identified between HGS and lung function at pre-operation and physiotherapy discharge. Handgrip strength was a significant predictor of lung function pre-operatively but not at physiotherapy discharge. Pre-operative lung function and HRQoL, as well as other variables, were significant predictors of lung function and HRQoL during physiotherapy discharge.
Undergoing cardiac surgery acutely and significantly reduced lung function, HGS and physical component of HRQoL in adults with cardiac disease. Assessment of HGS at physiotherapy discharge may be a poor indicator of operative changes in lung function and HRQoL. Clinicians may consider HGS as an inadequate tool in predicting lung function and HRQoL following cardiac surgery.
握力（HGS）、肺功能和健康相关生活质量（HRQoL）是未来心血管风险和死亡率的相关指标。心脏手术对这些预测变量的影响尚未得到充分探索。本研究的目的是确定接受择期心脏手术的成年人中 HGS、肺功能和 HRQoL 的急性（住院内）变化及其关系。此外，该研究还检查了这些变量与这些患者肺功能和 HRQoL 的预测因素之间的关系。
该研究是一项前瞻性队列研究，涉及 101 名患者，他们完成了术前（手术前 1-2 天）和物理治疗出院（手术后 5-7 天）评估。使用 JAMAR 测力计、Vitalograph-Alpha 或 EasyOne 肺活量计以及简短形式 36 问卷分别评估握力、肺功能和 HRQoL。使用配对 t 检验和 Pearson 相关系数分别分析这些变量的变化及其关系。使用回归分析使用 HGS 和其他协变量预测肺功能和 HRQoL。
在物理治疗出院时，与术前相比，肺功能、HGS 和 HRQoL 的物理成分明显（<0.001）降低。术前和物理治疗出院时，HGS 与肺功能之间存在显著（<0.001）和中度相关性。术前握力是肺功能的重要预测指标，但在物理治疗出院时不是。术前肺功能和 HRQoL 以及其他变量是物理治疗出院期间肺功能和 HRQoL 的重要预测指标。
心脏手术会使患有心脏病的成年人的肺功能、HGS 和 HRQoL 的物理成分急性且明显降低。在物理治疗出院时评估 HGS 可能无法很好地反映肺功能和 HRQoL 的手术变化。临床医生可能认为 HGS 是预测心脏手术后肺功能和 HRQoL 的不充分工具。
