Kazuhiro Hayashi1, Hideki Oshima2, Miho Shimizu3, Kiyonori Kobayashi3, Shigeyuki Matsui4, Yoshihiro Nishida5, Akihiko Usui2. 1. Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan; Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan; Department of Rehabilitation, Aichi Medical University, Nagakute, Japan. Electronic address: hayashi.kzhr@gmail.com. 2. Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. 3. Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan. 4. Department of Biostatics, Nagoya University Graduate School of Medicine, Nagoya, Japan. 5. Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan; Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Abstract
BACKGROUND: Postoperative cognitive dysfunction (POCD) is a neurologic dysfunction that occurs after surgery. POCD persists for a long period, ranging from weeks to months, and affects a patient's quality of life. A 6-minute walk distance (6MWD) has been used to predict postoperative complications after several operations. The present study investigated whether there was an independent association of a low preoperative 6MWD with POCD in patients who underwent cardiac operations. METHODS: The study included 181 patients who underwent a cardiac operation. The 6MWD was performed prospectively on admission for the operation. POCD was defined as a decrease of 2 points or more in a patient's Mini-Mental State Examination score. POCD developed in 51 (28%) of these patients. Patients were categorized into a POCD or a non-POCD group, and the perioperative variables were compared between the groups. Multivariable logistic regression analysis was performed to identify risk factors for the development of POCD. RESULTS: The patients were a mean age of 71.4 years. The POCD group showed a significantly lower 6MWD (median, 400 m) than the non-POCD group (median, 450 m). The 6MWD, intensive care unit length of stay, age, and Mini-Mental State Examination score were identified as independent risk factors for POCD by multivariable analysis. The odds ratio for each increase of 50 m in the 6MWD was 0.807 for POCD. CONCLUSIONS: The 6MWD is useful in identifying patients with a higher chance of developing POCD after a cardiac operation.
BACKGROUND:Postoperative cognitive dysfunction (POCD) is a neurologic dysfunction that occurs after surgery. POCD persists for a long period, ranging from weeks to months, and affects a patient's quality of life. A 6-minute walk distance (6MWD) has been used to predict postoperative complications after several operations. The present study investigated whether there was an independent association of a low preoperative 6MWD with POCD in patients who underwent cardiac operations. METHODS: The study included 181 patients who underwent a cardiac operation. The 6MWD was performed prospectively on admission for the operation. POCD was defined as a decrease of 2 points or more in a patient's Mini-Mental State Examination score. POCD developed in 51 (28%) of these patients. Patients were categorized into a POCD or a non-POCD group, and the perioperative variables were compared between the groups. Multivariable logistic regression analysis was performed to identify risk factors for the development of POCD. RESULTS: The patients were a mean age of 71.4 years. The POCD group showed a significantly lower 6MWD (median, 400 m) than the non-POCD group (median, 450 m). The 6MWD, intensive care unit length of stay, age, and Mini-Mental State Examination score were identified as independent risk factors for POCD by multivariable analysis. The odds ratio for each increase of 50 m in the 6MWD was 0.807 for POCD. CONCLUSIONS: The 6MWD is useful in identifying patients with a higher chance of developing POCD after a cardiac operation.
Authors: Elise Wiley; Kenneth S Noguchi; Kevin Moncion; Natalie D'Isabella; Daria A Shkredova; Hanna Fang; Julie Richardson; Joy C MacDermid; Lynden Rodrigues; Marc Roig; Ada Tang Journal: Front Rehabil Sci Date: 2022-09-12
Authors: Setayesh R Tasbihgou; Sandra Dijkstra; Sawal D Atmosoerodjo; Iris Tigchelaar; Rolf Huet; Massimo A Mariani; Anthony R Absalom Journal: PLoS One Date: 2020-10-13 Impact factor: 3.240