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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...

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Autores principales: Hartog, Johanneke, Mousavi, Iman, Dijkstra, Sandra, Fleer, Joke, van der Woude, Lucas H. V., van der Harst, Pim, Mariani, Massimo A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
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.
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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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