Influencing factors of the quality of postoperative rehabilitation of patients after cardiac large vessels surgery and establishment of prediction model

LI Ning; TIAN Shunping; MA Bei; LI Hu; GUAN Shiyu; ZHANG Jianyou; ZHANG Luo; WANG Qiang; ZHANG Zhuan

doi:10.7619/jcmp.20232783

Journal of Clinical Medicine in Practice > 2023 > 27(23): 47-53. > DOI: 10.7619/jcmp.20232783

LI Ning, TIAN Shunping, MA Bei, LI Hu, GUAN Shiyu, ZHANG Jianyou, ZHANG Luo, WANG Qiang, ZHANG Zhuan. Influencing factors of the quality of postoperative rehabilitation of patients after cardiac large vessels surgery and establishment of prediction model[J]. Journal of Clinical Medicine in Practice, 2023, 27(23): 47-53. DOI: 10.7619/jcmp.20232783

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Influencing factors of the quality of postoperative rehabilitation of patients after cardiac large vessels surgery and establishment of prediction model

LI Ning¹,
TIAN Shunping¹,
MA Bei²,
LI Hu^{1, 3},
GUAN Shiyu^{4, 5},
ZHANG Jianyou¹,
ZHANG Luo^1, ,,
WANG Qiang^{4, 5},
ZHANG Zhuan^{1, 5}

1.
Department of Anesthesiology, the Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, 225012
2.
Department of Operating Room, the Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, 225012
3.
Graduate School of Dalian Medical University, Dalian, Liaoning, 116044
4.
Heart and Great Vessels Center, the Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, 225012
5.
Institute of Cardiac Great Vessels Disease, Yangzhou University, Yangzhou, Jiangsu, 225012

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Received Date: September 02, 2023
Revised Date: October 11, 2023
Available Online: December 25, 2023

Graphical Abstract

Abstract

Abstract

Objective
To evaluate the quality of postoperative recovery of patients undergoing cardiac great vessels surgery by 15-item Recovery Quality Score Scale (QoR-15), to retrospectively analyze the influence of perioperative multi-factors on postoperative recovery quality, and to establish the predictive model.
Methods
Clinical data of patients who underwent cardiac great vascularsurgery from March 2020 to September 2022 were collected through electronic medical record system and the postoperative QoR-15 score were evaluated. The data including gender, age, postoperative follow-up time, American Society of Anesthesiologists (ASA) classification, preoperative lactate level, comorbidities, emergency or not, extracorporeal circulation or not, etc. were collected. The modified frailty index (mFI) was also calculated. Surgical patterns, operation time, extracorporeal circulation time, aortic block time, type of heart recurrence, perioperative fluid therapy, extracorporeal circulation temperature, and other postoperative data as well as postoperative data including ICU retention time after surgery, total length of stay and QoR-15 score were recorded. The univariate and multivariate Logistic regression analysis were then applied to construct a prediction model, and its accuracy was validated.
Results
A total of 213 patients were included, in which 15 patients were excluded, and 198 postoperative QoR-15 score sheets were received. Gender, ASA classification, preoperative lactate level, postoperative follow-up time, and mFI were significant influencing factors on the quality of rehabilitation of patients undergoing cardiac or great vascular surgery. The prediction model of ln(p/1-p)=-5.571+0.862×gender+3.844×ASA classification+3.143×preoperative lactate level+2.001×postoperative follow-up time+3.712×mFI, which had good predictive and classification effects.
Conclusion
Gender, ASA classification, preoperative lactate level, postoperative follow-up time and mFI are influencing factors on the recovery quality of patients after cardiac great vascular surgery.
- cardiac surgery,
- great vessel surgery,
- recovery quality,
- modified frailty index,
- regression analysis,
- prediction model

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References (24)

References

[1]	杨宇蝶, 贾科. 胸外科手术围术期的加速康复外科研究进展[J]. 实用临床医药杂志, 2021, 25(10): 119-123. doi: 10.7619/jcmp.20210104
[2]	陈凛, 陈亚进, 董海龙, 等. 加速康复外科中国专家共识及路径管理指南(2018版)[J]. 中国实用外科杂志, 2018, 38(1): 1-20. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWK201801001.htm
[3]	中华医学会外科学分会, 中华医学会麻醉学分会. 中国加速康复外科临床实践指南(2021版)[J]. 中国实用外科杂志, 2021, 41(9): 961-992. https://www.cnki.com.cn/Article/CJFDTOTAL-XHYX202105006.htm
[4]	KROMBACH J W, EDWARDS W A, MARKS J D, et al. Checklists and other cognitive aids for emergency and routine anesthesia care-a survey on the perception of anesthesia providers from a large academic US institution[J]. Anesth Pain Med, 2015, 5(4): e26300.
[5]	MYLES P S, SHULMAN M A, REILLY J, et al. Measurement of quality of recovery after surgery using the 15-item quality of recovery scale: a systematic review and meta-analysis[J]. Br J Anaesth, 2022, 128(6): 1029-1039. doi: 10.1016/j.bja.2022.03.009
[6]	KIM D, KIM J K, YEO J. Translation and validation of the Korean version of the postoperative quality of recovery score QoR-15[J]. Biomed Res Int, 2020, 2020: 3456234.
[7]	魏巍, 郑曦, 谷宇, 等. 改良衰弱指数对胸腔镜肺叶切除术老年患者术后肺部并发症的预测价值[J]. 临床麻醉学杂志, 2022, 38(5): 482-486. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ202205007.htm
[8]	BU X S, ZHANG J, ZUO Y X. Validation of the Chinese version of the quality of recovery-15 score and its comparison with the post-operative quality recovery scale[J]. Patient Patient Centered Outcomes Res, 2016, 9(3): 251-259. doi: 10.1007/s40271-015-0148-6
[9]	BROWN J K, SINGH K, DUMITRU R, et al. The benefits of enhanced recovery after surgery programs and their application in cardiothoracic surgery[J]. Methodist Debakey Cardiovasc J, 2018, 14(2): 77-88. doi: 10.14797/mdcj-14-2-77
[10]	KOŁODZIEJ T, MACIEJEWSKI T, MENDRALA K, et al. Enhanced recovery after cardiac surgery[J]. Kardiochirurgia I Torakochirurgia Polska, 2019, 16(1): 32-36.
[11]	J. R, A. R, C. R. Sex differences in the survival of multiple versus single arterial coronary artery bypass grafting[J]. Heart Lung Circ, 2023, 32: S324.
[12]	GAUDINO M, BAIREY MERZ C N, SANDNER S, et al. Randomized Comparison of the Outcome of Single Versus Multiple Arterial Grafts trial (ROMA): women-a trial dedicated to women to improve coronary bypass outcomes[J]. J Thorac Cardiovasc Surg, 2023: S0022-S5223(23)00525-1.
[13]	ALAMRI H M, ALOTAIBI T O, ALGHATANI A A, et al. Effect of gender on postoperative outcome and duration of ventilation after coronary artery bypass grafting (CABG)[J]. Cureus, 2023, 15(4): e37717.
[14]	ATIYA M, SCHORR E, STEIN L K, et al. Sex differences in ischemic stroke readmission rates and subsequent outcomes after coronary artery bypass graft surgery[J]. J Stroke Cerebrovasc Dis, 2021, 30(5): 105659. doi: 10.1016/j.jstrokecerebrovasdis.2021.105659
[15]	JABAGI H, TRAN D T, HESSIAN R, et al. Impact of gender on arterial revascularization strategies for coronary artery bypass grafting[J]. Ann Thorac Surg, 2018, 105(1): 62-68. doi: 10.1016/j.athoracsur.2017.06.054
[16]	DUNCAN A I, LIN J, KOCH C G, et al. The impact of gender on in-hospital mortality and morbidity after isolated aortic valve replacement[J]. Anesth Analg, 2006, 103(4): 800-808. doi: 10.1213/01.ane.0000231890.95212.12
[17]	COELHO P N M P, MIRANDA L M R P C, BARROS P M P, et al. Quality of life after elective cardiac surgery in elderly patients[J]. Interact Cardiovasc Thorac Surg, 2019, 28(2): 199-205. doi: 10.1093/icvts/ivy235
[18]	MARTÍNEZ-ORTEGA J M, NOGUERAS P, MUÑOZ-NEGRO J E, et al. Quality of life, anxiety and depressive symptoms in patients with psoriasis: a case-control study[J]. J Psychosom Res, 2019, 124: 109780. doi: 10.1016/j.jpsychores.2019.109780
[19]	KARA S, KÜPELI E, YILMAZ H E B, et al. Predicting pulmonary complications following upper and lower abdominal surgery: ASA vs. ARISCAT risk index[J]. Turk J Anaesthesiol Reanim, 2020, 48(2): 96-101.
[20]	YUCEL N, OZTURK DEMIR T, DERYA S, et al. Potential risk factors for In-hospital mortality in patients with moderate-to-severe blunt multiple trauma who survive initial resuscitation[J]. Emerg Med Int, 2018, 2018: 6461072.
[21]	BENNETT J M, WISE E S, HOCKING K M, et al. Hyperlactemia predicts surgical mortality in patients presenting with acute stanford type-a aortic dissection[J]. J Cardiothorac Vasc Anesth, 2017, 31(1): 54-60. doi: 10.1053/j.jvca.2016.03.133
[22]	WANG S, WANG D S, HUANG X F, et al. Risk factors and in-hospital mortality of postoperative hyperlactatemia in patients after acute type A aortic dissection surgery[J]. BMC Cardiovasc Disord, 2021, 21(1): 431. doi: 10.1186/s12872-021-02244-7
[23]	冯建梅, 冯建宇, 吴岩, 等. 四氢姜黄素对H9c2细胞缺血再灌注损伤的影响及机制研究[J]. 中国体外循环杂志, 2019, 17(1): 48-53. https://www.cnki.com.cn/Article/CJFDTOTAL-TWXH201901011.htm
[24]	CREAGH-BROWN B C, DE SILVA A P, FERRANDO-VIVAS P, et al. Relationship between peak lactate and patient outcome following high-risk gastrointestinal surgery: influence of the nature of their surgery: elective versus emergency[J]. Crit Care Med, 2016, 44(5): 918-925. doi: 10.1097/CCM.0000000000001567

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