Sarcopenia and Functional Recovery in Patients Undergoing Cardiac Surgery

• Main Authors: Chiao-Hsin Teng, 鄧喬欣
• Other Authors: Cheryl Chia-Hui Chen
• Format: Others
• Language: zh-TW
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/qvh3xs

碩士 === 國立臺灣大學 === 護理學研究所 === 105 === Background: Sarcopenia is identified as a predictor of length of hospital stay (LOS) and 30-day mortality after cardiac surgery. The impact of sarcopenia on functional changes in one-year after cardiac surgery remained unknown. Methods: We conducted a prospective cohort study to evaluate physical functions, preoperatively and 1, 3, 6, 12 months postoperatively, in 242 adult patients (≥ 20 years) who undergoing cardiac surgery. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria - lean mass index (LMI), grip strength (GS), and 5-meter walking speed was assessed before surgery. Primary outcomes were changes from presurgical baseline to postoperative follow-ups in activity of daily living (ADL) measured by Barthel index, physical activity (PA) measured by international physical activity questionnaire-short form in MET·min/week, grip strength (GS) in kg, walking distance measured by 6-minute walking test. Secondary outcomes included length of ICU stay, LOS and one-year mortality. All outcomes were compared between sarcopenia and non-sarcopenia groups. Results: Among 242 participants enrolled between Feburary 2013 and April 2017, sarcopenia presented in 22.3% (n=54) of our sample. The patients with sarcopenia were significantly older, having lower BMI, having higher EuroSCORE, and more dominated in women, patients with renal disease and non-smokers. Pre-surgically, all functional measures scored lower in sarcopenia group compared to non-sarcopenia group. Surprisingly, changes in functional status at 1, 3, 6, and 12 months postoperatively were not significantly differed between sarcopenia and non-sarcopenia groups in changes of ADL scores, grip strength, and walking distance from the presurgical baseline. On the other hand, PA changes of sarcopenia group weren’t significantly less until at 12 months [583.7 vs 1808.0 MET·min/week, p=0.004]. Nevertheless, the mean lengths of ICU and hospital stay were significantly longer for sarcopenia group [4.8 days vs 2.9 for non-sarcopenia group, p=0.03; 20.2 days vs 15.4, p=0.02]. But 1-year morality rate was not differed between sarcopenia and non-sarcopenia group [3.7% versus 3.2%, p=0.85]. Conclusions: Although the hospital duration was significantly longer for sarcopenia, the long-term surgical benefit of sarcopenia patients was comparable to non-sarcopenia. Sarcopenia is not a restriction for cardiac surgery.