Perioperative poor grip strength recovery is associated with 30-day complication rate after cardiac surgery discharge in middle-aged and older adults- a prospective observational study

Background: Although perioperative care during heart surgery has improved considerably, the rate of postoperative complications has remained stable. It has not been concluded how to better apply grip strength to clinical, postoperative complications. So our study aimed at researching the best way for using grip value for predicting early postoperative complications. Methods: A total of 212 patients with mean age 63.8±6.3 who underwent cardiac surgery included participated in our study. We analyzed the ROC curve of grip strength, grip/weight and grip recovery with complications, found the best cutoff point. Logistic regression confirmed the correlation between grip strength grouping and complications. Results: We found that 36 patients had 30-day complications. EuroSCORE were 2.15±1.52 and 2.42±1.58 between normal and complication groups, respectively. The area under the receiver-operating characteristic curve (AUC) of grip recovery take the most area (0.837, p<0.001), and the cutoff point was 83.92%. In logistic regression, lower grip recovery has higher risk impact on 30-day complications for 25.68 times than normal group, after adjusted surgery-related factors. After relisted characteristic information with grip recovery group , found that percentage of the estimated 6MWD (41.5 vs 48.3, p=0.028) and hospitalization time (7.2 vs 6.1, p=0.042) had worse trends in lower recovery group. Conclusions: Poor grip recovery may be related to higher risk of postoperative complications within 30 days after discharge in middle-aged and older people independent of surgical risk. The results of this study provide a reference for the development of rehabilitation programs in the early postoperative recovery, and may also be a prognostic indicator for postoperative high-risk groups.