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Impact of Frailty on Postoperative Dysphagia in Patients Undergoing Elective Cardiovascular Surgery

BACKGROUND: Postextubation dysphagia (PED) is a serious postoperative complication following cardiovascular surgery that can lead to a worse prognosis. On the other hand, frailty is a prognostic factor in patients who undergo cardiac surgery. OBJECTIVES: This study investigated the effect of frailty...

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Detalles Bibliográficos
Autores principales: Ogawa, Masato, Satomi-Kobayashi, Seimi, Yoshida, Naofumi, Komaki, Kodai, Izawa, Kazuhiro P., Hamaguchi, Mari, Inoue, Takeshi, Sakai, Yoshitada, Hirata, Ken-ichi, Okada, Kenji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9627818/
https://www.ncbi.nlm.nih.gov/pubmed/36340251
http://dx.doi.org/10.1016/j.jacasi.2021.10.011
Descripción
Sumario:BACKGROUND: Postextubation dysphagia (PED) is a serious postoperative complication following cardiovascular surgery that can lead to a worse prognosis. On the other hand, frailty is a prognostic factor in patients who undergo cardiac surgery. OBJECTIVES: This study investigated the effect of frailty status on PED and impact of PED on postoperative complications. METHODS: This single-center retrospective cohort study included 644 consecutive patients who underwent elective cardiovascular surgery between May 1, 2014, and December 31, 2020; they were assigned to the PED or non-PED group based on postoperative swallowing status, and postoperative complications were investigated. Frailty status and physical functions, including walking speed, grip strength, Short Physical Performance Battery, and 6-minute walking distance, were preoperatively assessed; the frailty-status cutoff for predicting PED was determined from the receiver-operating characteristic curve. RESULTS: In this study cohort (mean age 67.7 years), the overall PED prevalence was 14.8%; preoperative frailty had a significantly higher prevalence in the PED group (50.0%) than in the non-PED group (20.3%; P < 0.001). PED correlated with a higher incidence of postoperative pneumonia and prolonged intensive care unit or hospital stay (P < 0.05 for all). After adjustment for confounders, multiple regression analysis revealed that preoperative frailty was independently associated with PED (P < 0.001). CONCLUSIONS: PED occurred commonly after cardiovascular surgery and increased the risk of postoperative complications. Preoperative frailty was independently associated with PED. The 6-minute walking distance was the most powerful predictor of PED. Evaluation of preoperative frailty status is important for risk stratification and prevention of postoperative morbidity in patients undergoing surgery.