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Prehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis
BACKGROUND: The rising prevalence of modifiable lifestyle-related risk factors (e.g. overweight and physical inactivity) suggests the need for effective and safe preoperative interventions to improve outcomes after cardiac surgery. This retrospective study explored potential short-term postoperative...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284810/ https://www.ncbi.nlm.nih.gov/pubmed/34270545 http://dx.doi.org/10.1371/journal.pone.0253459 |
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author | Hartog, Johanneke Mousavi, Iman Dijkstra, Sandra Fleer, Joke van der Woude, Lucas H. V. van der Harst, Pim Mariani, Massimo A. |
author_facet | Hartog, Johanneke Mousavi, Iman Dijkstra, Sandra Fleer, Joke van der Woude, Lucas H. V. van der Harst, Pim Mariani, Massimo A. |
author_sort | Hartog, Johanneke |
collection | PubMed |
description | BACKGROUND: The rising prevalence of modifiable lifestyle-related risk factors (e.g. overweight and physical inactivity) suggests the need for effective and safe preoperative interventions to improve outcomes after cardiac surgery. This retrospective study explored potential short-term postoperative benefits and unintended consequences of a multidisciplinary prehabilitation program regarding in-hospital complications. METHODS: Data on patients who underwent elective cardiac surgery between January 2014 and April 2017 were analyzed retrospectively. Pearson’s chi-squared tests were used to compare patients who followed prehabilitation (three times per week, at a minimum of three weeks) during the waiting period with patients who received no prehabilitation. Sensitivity analyses were performed using propensity-score matching, in which the propensity score was based on the baseline variables that affected the outcomes. RESULTS: Of 1201 patients referred for elective cardiac surgery, 880 patients met the inclusion criteria, of whom 91 followed prehabilitation (53.8% ≥ 65 years, 78.0% male, median Euroscore II 1.3, IQR, 0.9–2.7) and 789 received no prehabilitation (60.7% ≥ 65 years, 69.6% male, median Euroscore II 1.6, IQR, 1.0–2.8). The incidence of atrial fibrillation (AF) was significantly lower in the prehabilitation group compared to the unmatched and matched standard care group (resp. 14.3% vs. 23.8%, P = 0.040 and 14.3% vs. 25.3%, P = 0.030). For the other complications, no between-group differences were found. CONCLUSIONS: Prehabilitation might be beneficial to prevent postoperative AF. Patients participated safely in prehabilitation and were not at higher risk for postoperative complications. However, well-powered randomized controlled trials are needed to confirm and deepen these results. |
format | Online Article Text |
id | pubmed-8284810 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-82848102021-07-28 Prehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis Hartog, Johanneke Mousavi, Iman Dijkstra, Sandra Fleer, Joke van der Woude, Lucas H. V. van der Harst, Pim Mariani, Massimo A. PLoS One Research Article BACKGROUND: The rising prevalence of modifiable lifestyle-related risk factors (e.g. overweight and physical inactivity) suggests the need for effective and safe preoperative interventions to improve outcomes after cardiac surgery. This retrospective study explored potential short-term postoperative benefits and unintended consequences of a multidisciplinary prehabilitation program regarding in-hospital complications. METHODS: Data on patients who underwent elective cardiac surgery between January 2014 and April 2017 were analyzed retrospectively. Pearson’s chi-squared tests were used to compare patients who followed prehabilitation (three times per week, at a minimum of three weeks) during the waiting period with patients who received no prehabilitation. Sensitivity analyses were performed using propensity-score matching, in which the propensity score was based on the baseline variables that affected the outcomes. RESULTS: Of 1201 patients referred for elective cardiac surgery, 880 patients met the inclusion criteria, of whom 91 followed prehabilitation (53.8% ≥ 65 years, 78.0% male, median Euroscore II 1.3, IQR, 0.9–2.7) and 789 received no prehabilitation (60.7% ≥ 65 years, 69.6% male, median Euroscore II 1.6, IQR, 1.0–2.8). The incidence of atrial fibrillation (AF) was significantly lower in the prehabilitation group compared to the unmatched and matched standard care group (resp. 14.3% vs. 23.8%, P = 0.040 and 14.3% vs. 25.3%, P = 0.030). For the other complications, no between-group differences were found. CONCLUSIONS: Prehabilitation might be beneficial to prevent postoperative AF. Patients participated safely in prehabilitation and were not at higher risk for postoperative complications. However, well-powered randomized controlled trials are needed to confirm and deepen these results. Public Library of Science 2021-07-16 /pmc/articles/PMC8284810/ /pubmed/34270545 http://dx.doi.org/10.1371/journal.pone.0253459 Text en © 2021 Hartog et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Hartog, Johanneke Mousavi, Iman Dijkstra, Sandra Fleer, Joke van der Woude, Lucas H. V. van der Harst, Pim Mariani, Massimo A. Prehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis |
title | Prehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis |
title_full | Prehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis |
title_fullStr | Prehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis |
title_full_unstemmed | Prehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis |
title_short | Prehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis |
title_sort | prehabilitation to prevent complications after cardiac surgery - a retrospective study with propensity score analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284810/ https://www.ncbi.nlm.nih.gov/pubmed/34270545 http://dx.doi.org/10.1371/journal.pone.0253459 |
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