老年患者心血管手术前相位角下降延长术后行走获得时间：一项回顾性、观察性、单中心研究

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-05-28 DOI:10.1016/j.clnesp.2025.05.042

Hiroyuki Takahashi , Junichi Yokota , Masanori Kanazawa , Seisho Takahashi , Takahiro Seki , Hitoshi Kudo , Hiroshi Honjo , Hideaki Endo , Katsuhiko Oda , Yoshiki Sakurada , Eiki Tsushima

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引用次数: 0

摘要

背景：心血管手术后长时间不活动与功能能力下降有关。早期心脏康复（CR）对老年虚弱和肌肉减少症患者至关重要。相角（PhA）是通过生物电阻抗分析（BIA）测量的骨骼肌质量的标志，与身体表现和长期预后相关；然而，其与术后康复进展的关系尚不清楚。目的：本研究探讨术前PhA与老年患者100米行走能力的关系。方法：对年龄≥65岁的择期心血管手术患者进行回顾性、观察性、单中心研究。主要指标是从手术到100米步行的天数。Kaplan-Meier生存曲线和Cox比例风险回归分析评价PhA与预后的关系。结果：97例患者中位PhA为4.9°，分为Low-PhA组（< 4.9°，n = 48）和High-PhA组（≥4.9°，n = 49）。低pha组需要更多的时间来获得100米步行，并且具有更低的100米步行获得率（log-rank P < 0.001）。Cox回归分析发现术前PhA是与100米行走习得相关的独立因素(HR, 1.519；95% ci: 1.078-2.140, p = 0.017)。结论：较低的术前PhA与接受心血管手术的老年患者延迟100米行走有关。

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Decline in the phase angle of older patients before cardiovascular surgery prolongs the postoperative walk acquisition time: A retrospective, observational, single-center study

Background

Prolonged postoperative inactivity after cardiovascular surgery is associated with a decline in functional capacity. Early cardiac rehabilitation (CR) is vital for older patients with frailty and sarcopenia. The phase angle (PhA), a marker of skeletal muscle quality measured by bioelectrical impedance analysis (BIA), is associated with physical performance and long-term outcomes; however, its relationship with postoperative rehabilitation progress remains unclear.

Objectives

This study investigated the relationship between preoperative PhA and 100-m walking acquisition in older patients.

Methods

A retrospective, observational, single-center study was conducted on patients aged ≥65 years who underwent elective cardiovascular surgery. The primary outcome was days from surgery to 100-m walking acquisition. Kaplan–Meier survival curves and Cox proportional hazards regression analyses were used to evaluate the relationship between PhA and outcomes.

Results

Among 97 patients, the median PhA was 4.9°, dividing them into Low-PhA (<4.9°, n = 48) and High-PhA (PhA≥ 4.9°, n = 49) groups. The Low-PhA group required significantly more days for 100-m walking acquisition and had lower 100-m walking acquisition rates (log-rank P < 0.001). Cox regression analysis identified preoperative PhA as an independent factor associated with 100-m walking acquisition (HR, 1.519; 95 % CI: 1.078–2.140, P = 0.017).

Conclusions

A lower preoperative PhA is associated with delayed 100-m walking acquisition in older patients undergoing cardiovascular surgery.

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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.