Hospitalization-Associated Disability After Cardiac Surgery in Elderly Patients　- Exploring the Risk Factors Using...

Area of Science:

• Gerontology
• Cardiology
• Clinical Medicine

Background:

• Hospitalization-associated disability (HAD) leads to functional decline and mortality in elderly patients post-discharge.
• Identifying risk factors for HAD is crucial for improving outcomes in elderly individuals undergoing cardiac surgery.

Purpose of the Study:

• To determine the incidence and identify risk factors associated with HAD in elderly patients undergoing elective cardiac surgery in Japan.

Main Methods:

• Retrospective analysis of 2,059 elderly patients undergoing cardiac surgery.
• HAD defined as functional decline (Barthel Index) from admission to discharge.
• Machine learning algorithms used to identify risk factors for HAD.

Main Results:

• 108 patients (5.2%) developed HAD.
• Identified risk factors include age, low serum albumin, impaired kidney function, cognitive impairment, NT-proBNP levels, low vital capacity, low preoperative SPPB scores, longer operation/bypass/ventilator times, prolonged ICU stay, and delayed ambulation.
• Highest HAD incidence (76.9%) in patients with SPPB ≤9 or ambulation start >6 days post-surgery.

Conclusions:

• Several identified risk factors for HAD are linked to frailty, suggesting preoperative rehabilitation can mitigate risk.
• Early mobilization and rehabilitation are critical, as evidenced by the association between delayed ambulation and increased HAD incidence.