心血管手术后六个月的相位角轨迹及心脏康复期间恢复的相关因素：一项回顾性队列研究。

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2024-11-19 DOI:10.1016/j.clnesp.2024.11.017

Kenichi Shibata , Masataka Kameshima , Takuji Adachi , Hisako Kito , Chikako Tanaka , Taisei Sano , Mizuki Tanaka , Masayuki Ida , Yoriyasu Suzuki , Hideki Kitamura

{"title":"心血管手术后六个月的相位角轨迹及心脏康复期间恢复的相关因素：一项回顾性队列研究。","authors":"Kenichi Shibata , Masataka Kameshima , Takuji Adachi , Hisako Kito , Chikako Tanaka , Taisei Sano , Mizuki Tanaka , Masayuki Ida , Yoriyasu Suzuki , Hideki Kitamura","doi":"10.1016/j.clnesp.2024.11.017","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and aims</h3><div>Although the phase angle (PhA), a measure of frailty and sarcopenia, determined by bioelectrical impedance analysis has been reported as a prognostic factor after cardiovascular surgery, few studies have reported the trajectory of the PhA after discharge. In this study, we examined the trajectory of the PhA along with conventional physical function measures and explored the factors associated with recovery for 6 months after hospital discharge in patients who had undergone cardiovascular surgery.</div></div><div><h3>Methods</h3><div>We included 116 patients who underwent elective cardiovascular surgery and cardiac rehabilitation after discharge. The PhA, physical function measures (grip strength, knee extension isometric muscle strength [KEIS], and usual gait speed), and Geriatric Nutritional Risk Index (GNRI) were assessed preoperatively, at discharge, and 3 and 6 months. Correlations between the PhA recovery rates and physical function and nutritional indices were assessed using Spearman's correlation analysis. Multivariate linear regression analysis was performed to examine the factors associated with recoveries of PhA and physical function indices (grip strength, KEIS, gait speed) after discharge.</div></div><div><h3>Results</h3><div>Mean values of the PhA and physical function measurements and the GNRI score at discharge were lower than the preoperative values (PhA, −8.0 %; grip strength, −8.7 %; KEIS, −6.9 %; usual gait speed, −8.3 %; GNRI, −11 %). The grip strength, KEIS, and gait speed recovered to almost preoperative values 3 months after discharge. Values for the PhA and GNRI were still lower than preoperative values 3 months after discharge but had recovered to preoperative values at 6 months. The PhA was not significantly correlated with the recovery rates of the other indicators. Older age was negatively associated with PhA recovery rate, however, recovery rates decreased significantly with post-discharge physical activity.</div></div><div><h3>Conclusions</h3><div>In patients undergoing cardiovascular surgery, the PhA takes longer to recover than muscle strength or gait speed, requiring up to 6 months to recover to preoperative levels. Post-discharge interventions to increase daily physical activity may be an important method of speeding PhA recovery.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 1-8"},"PeriodicalIF":2.9000,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Six-month trajectory of phase angle after cardiovascular surgery and associated factors of the recovery during cardiac rehabilitation: A retrospective cohort study\",\"authors\":\"Kenichi Shibata , Masataka Kameshima , Takuji Adachi , Hisako Kito , Chikako Tanaka , Taisei Sano , Mizuki Tanaka , Masayuki Ida , Yoriyasu Suzuki , Hideki Kitamura\",\"doi\":\"10.1016/j.clnesp.2024.11.017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and aims</h3><div>Although the phase angle (PhA), a measure of frailty and sarcopenia, determined by bioelectrical impedance analysis has been reported as a prognostic factor after cardiovascular surgery, few studies have reported the trajectory of the PhA after discharge. In this study, we examined the trajectory of the PhA along with conventional physical function measures and explored the factors associated with recovery for 6 months after hospital discharge in patients who had undergone cardiovascular surgery.</div></div><div><h3>Methods</h3><div>We included 116 patients who underwent elective cardiovascular surgery and cardiac rehabilitation after discharge. The PhA, physical function measures (grip strength, knee extension isometric muscle strength [KEIS], and usual gait speed), and Geriatric Nutritional Risk Index (GNRI) were assessed preoperatively, at discharge, and 3 and 6 months. Correlations between the PhA recovery rates and physical function and nutritional indices were assessed using Spearman's correlation analysis. Multivariate linear regression analysis was performed to examine the factors associated with recoveries of PhA and physical function indices (grip strength, KEIS, gait speed) after discharge.</div></div><div><h3>Results</h3><div>Mean values of the PhA and physical function measurements and the GNRI score at discharge were lower than the preoperative values (PhA, −8.0 %; grip strength, −8.7 %; KEIS, −6.9 %; usual gait speed, −8.3 %; GNRI, −11 %). The grip strength, KEIS, and gait speed recovered to almost preoperative values 3 months after discharge. Values for the PhA and GNRI were still lower than preoperative values 3 months after discharge but had recovered to preoperative values at 6 months. The PhA was not significantly correlated with the recovery rates of the other indicators. Older age was negatively associated with PhA recovery rate, however, recovery rates decreased significantly with post-discharge physical activity.</div></div><div><h3>Conclusions</h3><div>In patients undergoing cardiovascular surgery, the PhA takes longer to recover than muscle strength or gait speed, requiring up to 6 months to recover to preoperative levels. Post-discharge interventions to increase daily physical activity may be an important method of speeding PhA recovery.</div></div>\",\"PeriodicalId\":10352,\"journal\":{\"name\":\"Clinical nutrition ESPEN\",\"volume\":\"65 \",\"pages\":\"Pages 1-8\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2024-11-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical nutrition ESPEN\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2405457724015262\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical nutrition ESPEN","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405457724015262","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}

引用次数: 0

摘要

背景和目的：通过生物电阻抗分析确定的相位角（PhA）是衡量虚弱和肌肉疏松症的指标之一，有报道称它是心血管手术后的预后因素之一，但很少有研究报道出院后 PhA 的变化轨迹。在这项研究中，我们对心血管手术患者出院后 6 个月的 PhA 轨迹以及常规身体功能测量进行了研究，并探讨了与恢复相关的因素：我们纳入了116名接受择期心血管手术并在出院后接受心脏康复治疗的患者。我们在术前、出院时、3个月和6个月时评估了PhA、身体功能测量（握力、伸膝等长肌力[KEIS]和正常步速）以及老年营养风险指数（GNRI）。采用斯皮尔曼相关分析法评估 PhA 恢复率与身体功能和营养指数之间的相关性。采用多变量线性回归分析来研究与出院后 PhA 和身体功能指数（握力、KEIS、步速）恢复相关的因素：出院时的 PhA 和身体功能测量值以及 GNRI 评分的平均值均低于术前（PhA，-8.0%；握力，-8.7%；KEIS，-6.9%；通常步速，-8.3%；GNRI，-11%）。出院 3 个月后，握力、KEIS 和步速基本恢复到术前值。PhA 和 GNRI 值在出院 3 个月后仍低于术前值，但在 6 个月时已恢复到术前值。PhA 与其他指标的恢复率无明显相关性。年龄较大与PhA恢复率呈负相关，但恢复率随出院后体力活动的增加而明显下降：结论：在接受心血管手术的患者中，PhA的恢复时间要长于肌力或步态速度，需要长达6个月的时间才能恢复到术前水平。出院后增加日常体力活动的干预措施可能是加快 PhA 恢复的重要方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Six-month trajectory of phase angle after cardiovascular surgery and associated factors of the recovery during cardiac rehabilitation: A retrospective cohort study

Background and aims

Although the phase angle (PhA), a measure of frailty and sarcopenia, determined by bioelectrical impedance analysis has been reported as a prognostic factor after cardiovascular surgery, few studies have reported the trajectory of the PhA after discharge. In this study, we examined the trajectory of the PhA along with conventional physical function measures and explored the factors associated with recovery for 6 months after hospital discharge in patients who had undergone cardiovascular surgery.

Methods

We included 116 patients who underwent elective cardiovascular surgery and cardiac rehabilitation after discharge. The PhA, physical function measures (grip strength, knee extension isometric muscle strength [KEIS], and usual gait speed), and Geriatric Nutritional Risk Index (GNRI) were assessed preoperatively, at discharge, and 3 and 6 months. Correlations between the PhA recovery rates and physical function and nutritional indices were assessed using Spearman's correlation analysis. Multivariate linear regression analysis was performed to examine the factors associated with recoveries of PhA and physical function indices (grip strength, KEIS, gait speed) after discharge.

Results

Mean values of the PhA and physical function measurements and the GNRI score at discharge were lower than the preoperative values (PhA, −8.0 %; grip strength, −8.7 %; KEIS, −6.9 %; usual gait speed, −8.3 %; GNRI, −11 %). The grip strength, KEIS, and gait speed recovered to almost preoperative values 3 months after discharge. Values for the PhA and GNRI were still lower than preoperative values 3 months after discharge but had recovered to preoperative values at 6 months. The PhA was not significantly correlated with the recovery rates of the other indicators. Older age was negatively associated with PhA recovery rate, however, recovery rates decreased significantly with post-discharge physical activity.

Conclusions

In patients undergoing cardiovascular surgery, the PhA takes longer to recover than muscle strength or gait speed, requiring up to 6 months to recover to preoperative levels. Post-discharge interventions to increase daily physical activity may be an important method of speeding PhA recovery.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.