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

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