对需要手术的晚期心力衰竭患者进行多领域恢复力评估的可行性：一项试点研究。

Feasibility of a Multidomain Resiliency Assessment in Patients With Advanced Heart Failure Requiring Surgery: A Pilot Study.

作者信息

Green Karlyn J, North Rebecca, DeVore Adam D, Green Samantha, Poole Ashley K

机构信息

Doctor of Physical Therapy Program, Campbell University, Buies Creek, North Carolina, USA.

Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, North Carolina, USA.

出版信息

Phys Ther. 2024 Dec 6;104(12). doi: 10.1093/ptj/pzae135.

DOI:10.1093/ptj/pzae135

PMID:39255365

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12167756/

Abstract

OBJECTIVE

The resiliency of patients who have advanced heart failure (HF) and undergo a physical stressor such as heart transplantation or left ventricular assist device implantation has yet to be studied in the physical, cognitive, and psychosocial domains. The primary aim of this pilot study was to assess the feasibility of a multidomain resiliency assessment in patients who have advanced HF and require surgery.

METHODS

A battery of assessments in each of the domains was completed at baseline before surgical intervention, after intensive care discharge, and 3 and 6 months after surgery. Feasibility was assessed through completion rates, time required to complete the assessments, and qualitative feedback from assessors.

RESULTS

Although various completion rates were noted at different time points, high completion rates were seen for grip strength, the modified Fried frailty phenotype, and the Montreal Cognitive Assessment. Additionally, when controlled for patients who were medically restricted from physical function, the Short Physical Performance Battery, gait speed, and the 30-second chair stand test also had high completion rates. A trend toward return to baseline status or an improvement in baseline status was observed in all physical and cognitive assessments and most psychosocial assessments at 3 and 6 months. Minimal change was noted in the Brief Resilience Scale questionnaire.

CONCLUSION

This pilot study demonstrates that a multidomain assessment of resiliency is feasible in patients with advanced HF. Future studies are needed to help determine specific assessments or patient factors that would help predict positive postsurgical outcomes in this population.

IMPACT

This study has implications for clinical practice on the most feasible assessments in multiple domains for patients who have advanced HF and are being evaluated for heart transplantation or left ventricular assist device.

摘要

目的

晚期心力衰竭（HF）患者在经历心脏移植或植入左心室辅助装置等身体应激源后，其在身体、认知和社会心理领域的恢复力尚未得到研究。本初步研究的主要目的是评估对需要手术的晚期HF患者进行多领域恢复力评估的可行性。

方法

在手术干预前的基线、重症监护病房出院后以及术后3个月和6个月，完成每个领域的一系列评估。通过完成率、完成评估所需时间以及评估者的定性反馈来评估可行性。

结果

尽管在不同时间点观察到不同的完成率，但握力、改良的弗里德虚弱表型和蒙特利尔认知评估的完成率较高。此外，在对因身体功能受限而接受医学限制的患者进行控制后，简短体能测试、步速和30秒坐立试验的完成率也较高。在3个月和6个月时，所有身体和认知评估以及大多数社会心理评估中均观察到恢复到基线状态或基线状态改善的趋势。简短恢复力量表问卷的变化最小。