Post-graduate Program in Rehabilitation Sciences of the Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
Post-graduate Program in Rehabilitation Sciences of the Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
Braz J Phys Ther. 2023 Sep-Oct;27(5):100550. doi: 10.1016/j.bjpt.2023.100550. Epub 2023 Sep 21.
Functional limitation is relatively common and can negatively influence the postoperative outcome of patients after cardiac surgery.
To identify the predictive factors of functional limitation in patients undergoing elective cardiac surgery.
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.
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).
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.
功能受限较为常见，会对心脏手术后患者的术后转归产生负面影响。
确定行择期心脏手术患者发生功能受限的预测因素。
本回顾性队列研究纳入了行择期心脏手术的患者。所有患者均接受了心血管康复方案。心脏手术后根据康复方案中的表现来定义功能受限。心脏手术康复方案表现不佳定义为功能受限，表现良好则定义为无功能受限。
共纳入 548 例患者的数据，其中 190 例（34.7%）存在功能受限。多变量分析显示，与术后功能受限相关的因素如下：在公共医疗保健系统住院[比值比（OR）：2.14；95%置信区间（CI）：1.73，2.65]；年龄（OR：1.23；95%CI：1.15，1.31）；重症监护病房住院时间（OR：1.03；95%CI：1.01，1.05）；既往急性心肌梗死病史（OR：1.40；95%CI：1.13，1.73）；存在既往合并症[慢性肾脏病（OR：1.56；95%CI：1.15，2.10）；脑血管病（OR：1.57；95%CI：1.19，2.07）]；呼气肌无力（OR：1.54；95%CI：1.08，2.20）；住院期间发生心肺骤停（OR：1.76；95%CI：1.40，2.22）。
心脏手术后的功能受限可由多种术前和术后因素预测，除术前功能外，术前功能本身并不是术后功能受限的独立因素。
