Key result
Delayed walking after acute type A dissection surgery is linked to ~29% higher disability risk.
Observational (n=483)
No
Odds Ratio: 1.29 (95% CI 1.07–1.56)
p-value: p=0.008
Delayed walking onset, older age, use of noninvasive positive pressure ventilation, and postoperative delirium are significant risk factors for hospitalisation-associated disability after surgery for acute type A aortic dissection.
Delayed walking onset was associated with higher HAD risk after ATAAD repair; leaves open whether early mobilization reduces disability in prospective trials.
The in-hospital mortality rate among patients after surgery for acute type A aortic dissection (ATAAD) has improved chronologically. However, the relationship between the incidence of hospitalisation-associated disability (HAD) and acute cardiac rehabilitation in patients after surgery for ATAAD has not been reported. Therefore, this study evaluated factors related to HAD in patients after surgery for ATAAD. This single-centre retrospective observational study included 483 patients who required emergency surgery for ATAAD. HAD occurred in 104 (21.5%) patients following cardiovascular surgery. Factors associated with HAD were age (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.02–1.09; p = 0.001), noninvasive positive pressure ventilation (NPPV; OR, 2.15; 95% CI, 1.10–4.19; p = 0.025), postoperative delirium (OR, 2.93; 95% CI, 1.60–5.37; p = 0.001), and timing of walking onset (OR, 1.29; 95% CI, 1.07–1.56; p = 0.008). Furthermore, a late walking onset was associated with a higher risk of developing HAD and more severe functional decline. Early rehabilitation based on appropriate criteria has possibility of preventing HAD.
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Hirakawa et al. (2022) conducted an observational in Acute type A aortic dissection (post-surgery) (n=483). Delayed timing of walking onset vs. Early walking onset was evaluated on Hospitalisation-associated disability (HAD), defined as a decrease in Barthel index score of at least 5 points at discharge from the preoperative score (OR 1.29, 95% CI 1.07-1.56, p=0.008). A delay in the timing of walking onset after surgery for acute type A aortic dissection was significantly associated with an increased risk of hospitalisation-associated disability (OR 1.29).
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