Cardiac Infarct, Cardiac Valve Disease, Fragility, Physical Disability
Conditions
Keywords
Cardiac surgery, Short Physical Performance Battery, 1-minute sit-tostand test, Spirometry, muscular strength
Brief summary
The goal of this observational and prospective study is to investigate changes in physical performance, lung function, and respiratory and peripheral muscle strength in patients during the postoperative period following coronary artery bypass grafting (CABG) and valve replacement surgery..
Detailed description
This study aims to investigate the physical changes in patients undergoing myocardial revascularization surgery and valve replacement. It will observe alterations in physical performance, lung function, and muscle strength during the postoperative period. The study, observational and prospective, will include individuals aged ≥18 scheduled for these surgeries, evaluating them preoperatively, post-intensive care unit discharge, and before hospital discharge. Assessments involve tests like the Short Physical Performance Battery, 1-minute sit-to-stand test, Clinical Frailty Scale, manovacuometry, dynamometry, and spirometry to identify frailty and measure muscle and lung function. The study also aims to explore predictive variables for functional loss and mortality during hospitalization.
Interventions
None listed
Sponsors
University of Sao Paulo General Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years * Both genders * Elective coronary artery bypass grafting surgery * Elective Heart valve surgery * Absence of cognitive or peripheral motor impairment that prevents the performance of functional tests in the preoperative period.
Exclusion criteria
* Surgeries performed via lateral thoracotomy or minithoracotomy * Reoperation for any reason * Presence of cognitive or peripheral motor impairment that prevents the performance of functional tests in the postoperative period.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To investigate changes in physical performance measured by Short Physical Performance Battery (SPPB) | Baseline (one day before the surgery), after the surgery (the day immediately after ICU discharge) and through study completion, an average of 15 days. | Measures: walking speed, standing balance and sit-to-stand performance. |
| To investigate changes in physical performance measured by Six-Minute Walk Test. | Baseline (one day before the surgery), after the surgery (the day immediately after ICU discharge) and through study completion, an average of 15 days. | Measures: the assessment will take place in a flat 30-meter corridor, marked every 1 meter with non-slip flooring, and the patient will be instructed to walk for six minutes as fast as possible. |
| To investigate changes in physical performance by 1-minute sit-to-stand test (1-MSTST) | Baseline (one day before the surgery), after the surgery (the day immediately after ICU discharge) and through study completion, an average of 15 days. | Measure: number of 1-MSTST repetitions. |
| To investigate changes in peripheral muscle strength | Baseline (one day before the surgery), after the surgery (the day immediately after ICU discharge) and through study completion, an average of 15 days. | Measure: hand grip strengh measure (Kgf) |
| To investigate changes in respiratory muscle strength: | Baseline (one day before the surgery), after the surgery (the day immediately after ICU discharge) and through study completion, an average of 15 days. | Measures: maximal inspiratory and expiratory pressure (cmH2O) |
| To investigate changes in lung function test measure by spirometry: | Baseline (one day before the surgery), after the surgery (the day immediately after ICU discharge) and through study completion, an average of 15 days. | Measures: FVC (L), FEV1 (L), FEF (L/s) and FEF 25-75 (%) |
| To investigate frailty by Clinical Frailty Scale (CFS) | Baseline (one day before the surgery), after the surgery (the day immediately after ICU discharge) and through study completion, an average of 15 days. | The minimal value is 1 and the maximal is 9 in which the lowest scores mean worse outcomes. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| To explore potential preoperative and immediate postoperative risk factors as predictors of functional loss. | Baseline (one day before the surgery) during the immediate postoperative period. | Occurrence of comorbidities and clinical variables associated with functional decline |
| To investigate hemodynamic behavior during the Short Physical Performance Battery (SPPB). | Immediately before and after the SPPB. | Measures: heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure. |
| To investigate hemodynamic behavior during the 1-minute sit-to-stand test (1-MSTST). | Immediately before and after the 1-MSTST tests. | Measures: heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure. |
| To investigate respiratory behavior during the Short Physical Performance Battery (SPPB). | Immediately before and after the SPPB. | Measures: respiratory rate, Borg dyspnea scale and peripheral oxygen saturation. |
| To investigate respiratory behavior during 1-minute sit-to-stand test (1-1-MSTST). | Immediately before and after the 1-MSTST tests. | Measures: respiratory rate, Borg dyspnea scale and peripheral oxygen saturation. |
Countries
Brazil
Contacts
PRINCIPAL_INVESTIGATORRafael M Ianotti, PT
Instituto do Coração - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
Outcome results
None listed