Prevalence of frailty and associated factors in coronary artery bypass graft surgery patients

IF 2.9 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS European Journal of Cardiovascular Nursing Pub Date : 2024-07-17 DOI:10.1093/eurjcn/zvae098.081
B Arikan, F Demir Korkmaz
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引用次数: 0

Abstract

Background Frail patients are at increased risk for postoperative delirium, complications, delayed recovery, prolonged hospital and intensive care unit stay, morbidity and mortality. The number of studies examining frailty in cardiovascular surgery patients is limited (1,2). In this context, it is important to determine the prevalence of frailty in cardiac surgery patients (3,4). Purpose This research was conducted to examine the prevalence of frailty in coronary artery bypass graft surgery patients and associated factors with frailty. Methods The research was descriptive cross-sectional type. It was conducted between 18.02.2021 and 18.02.2022 at the cardiovascular surgery department of a training and research hospital in Turkey. A total of 96 patients who had undergone coronary artery bypass graft (CABG) were included. The "Sociodemographic and Clinical Data Form" which was prepared in accordance with the literature, the "Modified Fried Frailty Index", the "Mini Nutritional Assessment Test-Short Form", the "Barthel Daily Living Activities Index", the "Charlson Comorbidity Index", and the "Montreal Cognitive Assessment Scale" were used to collect data. The data were analyzed using the SPSS 23.0 package program. Descriptive statistics, Kolmogorov-Smirnov test, Chi-square test, One Way ANOVA, Kruskal Wallis test and multinomial logistic regression analysis were used in the evaluation of the data. Results As a result of the study, the mean age of the patients was 65.65±8.72 years (min:40-max:85), 62.5% consisted of males. The majority of patients (94.8%) had comorbid diseases, most of whom had hypertension (66.7%) and diabetes mellitus (63.5%). The mean ejection fraction of the patients was normal (54.59±8.70) according to the European Society of Cardiology and the majority (80.2%) were in the preserved LVEF group. The mean EuroSCORE was intermediate (4.79±2.40) and 49% of the patients were at intermediate risk for mortality. The majority of the patients (94.8%) were in the ASA III class according to the American Society of Anaesthesiologists. Of the patients. 14.6% were determined as ‘non-frail’, 45.8% as ‘pre-frail’ and 39.6% as ‘frail’. Age, educational status, income level, beta-blocker use, nutritional status, daily living activities, cognitive status, number of comorbidities, and level of potassium, procalcitonin and creatinine were found to be associated with frailty (p<0.05). Malnutrition, decreased daily living activity, cognitive impairment and creatinine elevation were found to be predictors of frailty (p<0.05). Sociodemographic and Clinical Characteristics by Frailty Status was presented in Table 1. Conclusions More than a third of CABG patients were frail. Malnutrition, decreased daily living activity, impaired cognitive status and high creatinine levels increased the risk. It is important to assesment frail cardiac surgery patients and provide them with appropriate nursing management.
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冠状动脉旁路移植手术患者体弱的普遍性及相关因素
背景 脆弱的患者术后出现谵妄、并发症、康复延迟、住院和重症监护室留院时间延长、发病率和死亡率的风险都会增加。针对心血管手术患者体弱情况的研究数量有限(1,2)。在这种情况下,确定心脏手术患者的虚弱患病率就显得尤为重要 (3,4)。目的 本研究旨在探讨冠状动脉旁路移植手术患者的虚弱发生率以及与虚弱相关的因素。方法 该研究为描述性横断面研究。研究于 2021 年 2 月 18 日至 2022 年 2 月 18 日在土耳其一家培训和研究医院的心血管外科进行。共纳入了 96 名接受过冠状动脉搭桥术(CABG)的患者。收集数据时使用了根据文献编制的 "社会人口学和临床数据表"、"改良弗里德虚弱指数"、"迷你营养评估测试短表"、"巴特尔日常生活活动指数"、"查尔森合并症指数 "和 "蒙特利尔认知评估量表"。数据使用 SPSS 23.0 软件包进行分析。在评估数据时使用了描述性统计、Kolmogorov-Smirnov 检验、Chi-square 检验、单向方差分析、Kruskal Wallis 检验和多项式逻辑回归分析。结果 研究结果显示,患者的平均年龄为(65.65±8.72)岁(最小:40-最大:85),62.5%为男性。大多数患者(94.8%)患有合并症,其中大多数患有高血压(66.7%)和糖尿病(63.5%)。根据欧洲心脏病学会的标准,患者的平均射血分数为正常值(54.59±8.70),大多数患者(80.2%)属于LVEF保留组。平均EuroSCORE为中等水平(4.79±2.40),49%的患者处于中度死亡风险。大多数患者(94.8%)属于美国麻醉学会 ASA III 级。患者中14.6%被确定为 "非虚弱",45.8%为 "前期虚弱",39.6%为 "虚弱"。研究发现,年龄、教育状况、收入水平、β-受体阻滞剂的使用、营养状况、日常生活活动、认知状况、合并症数量以及血钾、降钙素原和肌酐水平与体弱有关(p<0.05)。营养不良、日常生活活动减少、认知障碍和肌酐升高被认为是体弱的预测因素(p<0.05)。表 1 列出了按虚弱状态划分的社会人口学和临床特征。结论 超过三分之一的 CABG 患者体质虚弱。营养不良、日常生活活动减少、认知能力受损和肌酐水平过高都会增加风险。对体弱的心脏手术患者进行评估并提供适当的护理管理非常重要。
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来源期刊
European Journal of Cardiovascular Nursing
European Journal of Cardiovascular Nursing CARDIAC & CARDIOVASCULAR SYSTEMS-NURSING
CiteScore
5.10
自引率
10.30%
发文量
247
审稿时长
6-12 weeks
期刊介绍: The peer-reviewed journal of the European Society of Cardiology’s Council on Cardiovascular Nursing and Allied Professions (CCNAP) covering the broad field of cardiovascular nursing including chronic and acute care, cardiac rehabilitation, primary and secondary prevention, heart failure, acute coronary syndromes, interventional cardiology, cardiac care, and vascular nursing.
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