What is the clinical evidence from this study?

Study design: Cohort. Population: Elective cardiac surgery (n=3382). Intervention: Decreased physical activity (sedentary lifestyle) vs. Active lifestyle. Primary outcome: Postoperative complicated recovery (PCR) in patients aged >65 and ≤75 years (OR 1.717, 95% CI 1.206-2.443, p=0.003).

January 1, 2017Health and Quality of Life OutcomesOpen Access

Decreased physical activity is a predictor for a complicated recovery post cardiac surgery

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Key result

Decreased physical activity predicts ~72% higher risk of complicated recovery after elective cardiac surgery.

OR 1.717
95% CI 1.206-2.443
P=0.003
n=3,382

Why the study?

Does decreased physical activity predict postoperative complicated recovery in patients undergoing elective cardiac surgery?

Population

3,382 patients undergoing elective cardiac surgery between January 2007 and December 2013, divided into age…

Comparison

Decreased physical activity vs Normal or higher physical activity

Design

Cohort

Follow-up

Postoperative hospital stay

Authors

CLCharlotte van LaarSt. Antonius Ziekenhuis STSimone T. TimmanRadboud University Nijmegen LNL. NoyezRadboud University Nijmegen

Discussion

Member takes

Implication

Decreased physical activity was associated with complicated recovery after elective cardiac surgery in older adults; leaves open whether preoperative interventions improve outcomes.

Study Design

Type

Cohort (n=3,382)

Multicenter

Structured PICO

Does decreased physical activity predict postoperative complicated recovery in patients undergoing elective cardiac surgery?

Population

3,382 patients undergoing elective cardiac surgery between January 2007 and December 2013, divided into age groups ≤65 years (n=1329), >65 to ≤75 years (n=1250), and >75 years (n=803).

Intervention

Decreased physical activity (assessed by Corpus Christy Heart Project criteria)

Comparator

Normal or higher physical activity

Outcome

Postoperative complicated recovery (PCR), defined as a composite of reoperation, deep sternal wound infection, renal failure, stroke, postoperative ventilation > 2 days, intensive care stay ≥ 5 days, hospital stay ≥ 10 days, or hospital mortalitycomposite

Main Result

Effect estimate: OR 1.717 (95% CI 1.206-2.443)

Absolute Event Rate: 17.8% vs 9.8%

p-value: p=0.003

Decreased physical activity prior to elective cardiac surgery is an independent predictor of a complicated postoperative recovery in patients over 65 years of age.

Limitations

Used a self-reporting assessment (CCHP criteria) to evaluate physical activity, which may overestimate true exercise activity and lack specificity.
Did not distinguish between different underlying causes of decreased physical activity such as cardiac, vascular, neurological pathology, or frailty.
Retrospective, single-center study design.
Missing data due to voluntary survey participation, which excluded patients at higher risk and with higher percentages of complicated recovery.

Cite This Study

Laar et al. (2017) conducted a cohort in Elective cardiac surgery (n=3,382). Decreased physical activity (sedentary lifestyle) vs. Active lifestyle was evaluated on Postoperative complicated recovery (PCR) in patients aged >65 and ≤75 years (OR 1.717, 95% CI 1.206-2.443, p=0.003). Decreased physical activity independently predicted a complicated postoperative recovery in patients aged >65 to 75 years (OR 1.717) and >75 years (OR 1.488) undergoing elective cardiac surgery.

synapsesocial.com/papers/6a0513ff6c3d07813971bcd1 https://doi.org/10.1186/s12955-016-0576-6

Topics

Women and heart disease

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Implication

Decreased physical activity was associated with complicated recovery after elective cardiac surgery in older adults; leaves open whether preoperative interventions improve outcomes.

Decreased physical activity is a predictor for a complicated recovery post cardiac surgery

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Decreased physical activity is a predictor for a complicated recovery post cardiac surgery

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider