Association of Preoperative Functional Status With Short-Term Major Adverse Outcomes After Cardiac Surgery

Area of Science:

• Cardiology
• Geriatric Medicine
• Surgical Outcomes Research

Background:

• Cardiac surgery is vital for cardiovascular conditions but carries significant risks.
• An aging population and comorbidities increase the number of patients with suboptimal preoperative functional status.
• Preoperative functional status assessment is crucial for improving patient selection and outcomes.

Purpose of the Study:

• To investigate the association between preoperative dependent functional status and major adverse outcomes in cardiac surgery patients.
• To determine if functional status is an independent predictor of postoperative complications.

Main Methods:

• Retrospective cohort analysis of adult cardiac surgery patients using the ACS NSQIP database (2011-2021).
• Comparison of a composite outcome of major adverse events between independent and dependent functional status groups.
• Multivariable logistic regression analysis adjusted for demographics, comorbidities, and laboratory markers.

Main Results:

• Dependent patients had a higher incidence of the primary composite outcome (35.68% vs. 20.93%).
• Preoperative dependent functional status remained significantly associated with increased risk (OR 1.21, 95% CI 1.04-1.41) after multivariable adjustment.
• Prevalence of dependent status was 2.6% in the study cohort of 42,917 patients.

Conclusions:

• Preoperative dependent functional status is a significant risk factor for major adverse outcomes following cardiac surgery.
• Incorporating functional status into preoperative evaluations can aid in identifying high-risk patients.
• Further research is needed to develop predictive tools and clinical applications, such as prehabilitation programs, to mitigate risks in this population.