Prehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis.

<h4>Background</h4>The rising prevalence of modifiable lifestyle-related risk factors (e.g. overweight and physical inactivity) suggests the need for effective and safe preoperative interventions to improve outcomes after cardiac surgery. This retrospective study explored potential short...

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Autores principales:	Johanneke Hartog, Iman Mousavi, Sandra Dijkstra, Joke Fleer, Lucas H V van der Woude, Pim van der Harst, Massimo A Mariani
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/591a8eae4989455e8bf4952cc689248c
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spelling	oai:doaj.org-article:591a8eae4989455e8bf4952cc689248c2021-12-02T20:05:02ZPrehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis.1932-620310.1371/journal.pone.0253459https://doaj.org/article/591a8eae4989455e8bf4952cc689248c2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253459https://doaj.org/toc/1932-6203<h4>Background</h4>The rising prevalence of modifiable lifestyle-related risk factors (e.g. overweight and physical inactivity) suggests the need for effective and safe preoperative interventions to improve outcomes after cardiac surgery. This retrospective study explored potential short-term postoperative benefits and unintended consequences of a multidisciplinary prehabilitation program regarding in-hospital complications.<h4>Methods</h4>Data on patients who underwent elective cardiac surgery between January 2014 and April 2017 were analyzed retrospectively. Pearson's chi-squared tests were used to compare patients who followed prehabilitation (three times per week, at a minimum of three weeks) during the waiting period with patients who received no prehabilitation. Sensitivity analyses were performed using propensity-score matching, in which the propensity score was based on the baseline variables that affected the outcomes.<h4>Results</h4>Of 1201 patients referred for elective cardiac surgery, 880 patients met the inclusion criteria, of whom 91 followed prehabilitation (53.8% ≥ 65 years, 78.0% male, median Euroscore II 1.3, IQR, 0.9-2.7) and 789 received no prehabilitation (60.7% ≥ 65 years, 69.6% male, median Euroscore II 1.6, IQR, 1.0-2.8). The incidence of atrial fibrillation (AF) was significantly lower in the prehabilitation group compared to the unmatched and matched standard care group (resp. 14.3% vs. 23.8%, P = 0.040 and 14.3% vs. 25.3%, P = 0.030). For the other complications, no between-group differences were found.<h4>Conclusions</h4>Prehabilitation might be beneficial to prevent postoperative AF. Patients participated safely in prehabilitation and were not at higher risk for postoperative complications. However, well-powered randomized controlled trials are needed to confirm and deepen these results.Johanneke HartogIman MousaviSandra DijkstraJoke FleerLucas H V van der WoudePim van der HarstMassimo A MarianiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0253459 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Johanneke Hartog Iman Mousavi Sandra Dijkstra Joke Fleer Lucas H V van der Woude Pim van der Harst Massimo A Mariani Prehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis.
description	<h4>Background</h4>The rising prevalence of modifiable lifestyle-related risk factors (e.g. overweight and physical inactivity) suggests the need for effective and safe preoperative interventions to improve outcomes after cardiac surgery. This retrospective study explored potential short-term postoperative benefits and unintended consequences of a multidisciplinary prehabilitation program regarding in-hospital complications.<h4>Methods</h4>Data on patients who underwent elective cardiac surgery between January 2014 and April 2017 were analyzed retrospectively. Pearson's chi-squared tests were used to compare patients who followed prehabilitation (three times per week, at a minimum of three weeks) during the waiting period with patients who received no prehabilitation. Sensitivity analyses were performed using propensity-score matching, in which the propensity score was based on the baseline variables that affected the outcomes.<h4>Results</h4>Of 1201 patients referred for elective cardiac surgery, 880 patients met the inclusion criteria, of whom 91 followed prehabilitation (53.8% ≥ 65 years, 78.0% male, median Euroscore II 1.3, IQR, 0.9-2.7) and 789 received no prehabilitation (60.7% ≥ 65 years, 69.6% male, median Euroscore II 1.6, IQR, 1.0-2.8). The incidence of atrial fibrillation (AF) was significantly lower in the prehabilitation group compared to the unmatched and matched standard care group (resp. 14.3% vs. 23.8%, P = 0.040 and 14.3% vs. 25.3%, P = 0.030). For the other complications, no between-group differences were found.<h4>Conclusions</h4>Prehabilitation might be beneficial to prevent postoperative AF. Patients participated safely in prehabilitation and were not at higher risk for postoperative complications. However, well-powered randomized controlled trials are needed to confirm and deepen these results.
format	article
author	Johanneke Hartog Iman Mousavi Sandra Dijkstra Joke Fleer Lucas H V van der Woude Pim van der Harst Massimo A Mariani
author_facet	Johanneke Hartog Iman Mousavi Sandra Dijkstra Joke Fleer Lucas H V van der Woude Pim van der Harst Massimo A Mariani
author_sort	Johanneke Hartog
title	Prehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis.
title_short	Prehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis.
title_full	Prehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis.
title_fullStr	Prehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis.
title_full_unstemmed	Prehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis.
title_sort	prehabilitation to prevent complications after cardiac surgery - a retrospective study with propensity score analysis.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/591a8eae4989455e8bf4952cc689248c
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Prehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis.

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