Lower extremity performance predicts length of hospital stay in older candidates to elective cardiac surgery

• Published in: Experimental gerontology 2022-07, Vol.164, p.111801-111801, Article 111801
• Main Authors: Baldasseroni, Samuele, Di Bari, Mauro, Stefàno, Pierluigi, Pratesi, Alessandra, Mossello, Enrico, Ungar, Andrea, Del Pace, Stefano, Orso, Francesco, Herbst, Andrea, Lucarelli, Giulia, Fumagalli, Carlo, Olivo, Giuseppe, Marchionni, Niccolò
• Format: Article
• Language: English
• Subjects: Cardiac surgery; Elderly; Performance measure; Prolonged hospitalization; Short Physical Performance Battery
• ISSN: 0531-5565; 1873-6815
• DOI: 10.1016/j.exger.2022.111801

Prolonged hospital stay must be considered as risk factor for poor outcomes after cardiac surgery; different variables have been advocated as predictors of in-hospital stay. Nevertheless, most patients requiring prolonged hospital stay are frail older subjects; thus, we hypothesized a significant influence of pre-operative physical performance, as a frailty measure, on in-hospital stay after elective cardiac surgery. In a prospective, single-center, cohort study we enrolled patients aged 75+ years referred to our Division of Cardiac Surgery at Careggi University Hospital, for their first elective cardiac surgery. All participants were preoperatively evaluated by a team composed by a cardiac surgeon, a cardiologist, an anaesthesist, and a geriatrician to assess global cardiac surgery risk; lower extremity performance was measured with the Short Physical Performance Battery-SPPB. A total of 518 patients were included in the study. Mean age was 79.5 ± 3.3 years; 256 (49.4%) were women. Isolated coronary by pass graft was performed in 37 patients (7.1%), isolated valve surgery in 115 (22.0%), and combined cardiac surgery procedures in 366 (70,9%). In a multivariable model, SPPB score was strongly associated with hospital length of stay both as continuous, categorized and dichotomous variable (p