Cargando…
Decreased activities of daily living at discharge predict mortality and readmission in elderly patients after cardiac and aortic surgery: A retrospective cohort study
Recently, activities of daily living (ADL) were identified as a prognostic factor among elderly patients with heart disease; however, a specific association between ADL and prognosis after cardiac and aortic surgery is not well established. We aimed to clarify the impact of ADL capacity at discharge...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8341368/ https://www.ncbi.nlm.nih.gov/pubmed/34397842 http://dx.doi.org/10.1097/MD.0000000000026819 |
_version_ | 1783733912135008256 |
---|---|
author | Sato, Masaaki Mutai, Hitoshi Yamamoto, Shuhei Tsukakoshi, Daichi Takeda, Shuhei Oguchi, Natsuko Ichimura, Hajime Ikegami, Shota Wada, Yuko Seto, Tatsuichiro Horiuchi, Hiroshi |
author_facet | Sato, Masaaki Mutai, Hitoshi Yamamoto, Shuhei Tsukakoshi, Daichi Takeda, Shuhei Oguchi, Natsuko Ichimura, Hajime Ikegami, Shota Wada, Yuko Seto, Tatsuichiro Horiuchi, Hiroshi |
author_sort | Sato, Masaaki |
collection | PubMed |
description | Recently, activities of daily living (ADL) were identified as a prognostic factor among elderly patients with heart disease; however, a specific association between ADL and prognosis after cardiac and aortic surgery is not well established. We aimed to clarify the impact of ADL capacity at discharge on prognosis in elderly patients after cardiac and aortic surgery. This retrospective cohort study included 171 elderly patients who underwent open operation for cardiovascular disease in a single center (median age: 74 years; men: 70%). We used the Barthel Index (BI) as an indicator for ADL. Patients were classified into 2 groups according to the BI at discharge, indicating a high (BI ≥ 85) or low (BI < 85) ADL status. All-cause mortality and unplanned readmission events were observed after discharge. Thirteen all-cause mortality and 44 all-cause unplanned readmission events occurred during the median follow-up of 365 days. Using Kaplan–Meier analysis, a low ADL status was determined to be significantly associated with all-cause mortality and unplanned readmission. In the multivariable Cox proportional hazard models, a low ADL status was an independent predictor of all-cause mortality and unplanned readmission after adjusting for age, sex, length of hospital stay, and other variables (including preoperative status, surgical parameter, and postoperative course). A low ADL status at discharge predicted all-cause mortality and unplanned readmission in elderly patients after cardiac and aortic surgery. A comprehensive approach from the time of admission to postdischarge to improve ADL capacity in elderly patients undergoing cardiac and aortic surgery may improve patient outcomes. |
format | Online Article Text |
id | pubmed-8341368 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-83413682021-08-07 Decreased activities of daily living at discharge predict mortality and readmission in elderly patients after cardiac and aortic surgery: A retrospective cohort study Sato, Masaaki Mutai, Hitoshi Yamamoto, Shuhei Tsukakoshi, Daichi Takeda, Shuhei Oguchi, Natsuko Ichimura, Hajime Ikegami, Shota Wada, Yuko Seto, Tatsuichiro Horiuchi, Hiroshi Medicine (Baltimore) 3400 Recently, activities of daily living (ADL) were identified as a prognostic factor among elderly patients with heart disease; however, a specific association between ADL and prognosis after cardiac and aortic surgery is not well established. We aimed to clarify the impact of ADL capacity at discharge on prognosis in elderly patients after cardiac and aortic surgery. This retrospective cohort study included 171 elderly patients who underwent open operation for cardiovascular disease in a single center (median age: 74 years; men: 70%). We used the Barthel Index (BI) as an indicator for ADL. Patients were classified into 2 groups according to the BI at discharge, indicating a high (BI ≥ 85) or low (BI < 85) ADL status. All-cause mortality and unplanned readmission events were observed after discharge. Thirteen all-cause mortality and 44 all-cause unplanned readmission events occurred during the median follow-up of 365 days. Using Kaplan–Meier analysis, a low ADL status was determined to be significantly associated with all-cause mortality and unplanned readmission. In the multivariable Cox proportional hazard models, a low ADL status was an independent predictor of all-cause mortality and unplanned readmission after adjusting for age, sex, length of hospital stay, and other variables (including preoperative status, surgical parameter, and postoperative course). A low ADL status at discharge predicted all-cause mortality and unplanned readmission in elderly patients after cardiac and aortic surgery. A comprehensive approach from the time of admission to postdischarge to improve ADL capacity in elderly patients undergoing cardiac and aortic surgery may improve patient outcomes. Lippincott Williams & Wilkins 2021-08-06 /pmc/articles/PMC8341368/ /pubmed/34397842 http://dx.doi.org/10.1097/MD.0000000000026819 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) |
spellingShingle | 3400 Sato, Masaaki Mutai, Hitoshi Yamamoto, Shuhei Tsukakoshi, Daichi Takeda, Shuhei Oguchi, Natsuko Ichimura, Hajime Ikegami, Shota Wada, Yuko Seto, Tatsuichiro Horiuchi, Hiroshi Decreased activities of daily living at discharge predict mortality and readmission in elderly patients after cardiac and aortic surgery: A retrospective cohort study |
title | Decreased activities of daily living at discharge predict mortality and readmission in elderly patients after cardiac and aortic surgery: A retrospective cohort study |
title_full | Decreased activities of daily living at discharge predict mortality and readmission in elderly patients after cardiac and aortic surgery: A retrospective cohort study |
title_fullStr | Decreased activities of daily living at discharge predict mortality and readmission in elderly patients after cardiac and aortic surgery: A retrospective cohort study |
title_full_unstemmed | Decreased activities of daily living at discharge predict mortality and readmission in elderly patients after cardiac and aortic surgery: A retrospective cohort study |
title_short | Decreased activities of daily living at discharge predict mortality and readmission in elderly patients after cardiac and aortic surgery: A retrospective cohort study |
title_sort | decreased activities of daily living at discharge predict mortality and readmission in elderly patients after cardiac and aortic surgery: a retrospective cohort study |
topic | 3400 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8341368/ https://www.ncbi.nlm.nih.gov/pubmed/34397842 http://dx.doi.org/10.1097/MD.0000000000026819 |
work_keys_str_mv | AT satomasaaki decreasedactivitiesofdailylivingatdischargepredictmortalityandreadmissioninelderlypatientsaftercardiacandaorticsurgeryaretrospectivecohortstudy AT mutaihitoshi decreasedactivitiesofdailylivingatdischargepredictmortalityandreadmissioninelderlypatientsaftercardiacandaorticsurgeryaretrospectivecohortstudy AT yamamotoshuhei decreasedactivitiesofdailylivingatdischargepredictmortalityandreadmissioninelderlypatientsaftercardiacandaorticsurgeryaretrospectivecohortstudy AT tsukakoshidaichi decreasedactivitiesofdailylivingatdischargepredictmortalityandreadmissioninelderlypatientsaftercardiacandaorticsurgeryaretrospectivecohortstudy AT takedashuhei decreasedactivitiesofdailylivingatdischargepredictmortalityandreadmissioninelderlypatientsaftercardiacandaorticsurgeryaretrospectivecohortstudy AT oguchinatsuko decreasedactivitiesofdailylivingatdischargepredictmortalityandreadmissioninelderlypatientsaftercardiacandaorticsurgeryaretrospectivecohortstudy AT ichimurahajime decreasedactivitiesofdailylivingatdischargepredictmortalityandreadmissioninelderlypatientsaftercardiacandaorticsurgeryaretrospectivecohortstudy AT ikegamishota decreasedactivitiesofdailylivingatdischargepredictmortalityandreadmissioninelderlypatientsaftercardiacandaorticsurgeryaretrospectivecohortstudy AT wadayuko decreasedactivitiesofdailylivingatdischargepredictmortalityandreadmissioninelderlypatientsaftercardiacandaorticsurgeryaretrospectivecohortstudy AT setotatsuichiro decreasedactivitiesofdailylivingatdischargepredictmortalityandreadmissioninelderlypatientsaftercardiacandaorticsurgeryaretrospectivecohortstudy AT horiuchihiroshi decreasedactivitiesofdailylivingatdischargepredictmortalityandreadmissioninelderlypatientsaftercardiacandaorticsurgeryaretrospectivecohortstudy |