Preditores da Velocidade da Marcha e Fatores Associados ao Estado Funcional em Pacientes no Pósoperatório de Cirurgia Cardíaca: Uma Coorte Prospectiva

Abstract

Introduction – Cardiac surgery may impact physical function. In this context, knowing the factors that impact gait speed and functional status during postoperative period after cardiac surgery may help to identify institution's demand for intervention in order to prevent the incidence of functional impairment. Objective – To investigate gait speed predictors and factors associated with functional status in individuals undergoing postoperative period after cardiac surgery. Methods – It is a prospective cohort study that was performed in a tertiary hospital in Salvador, Bahia, Brazil. Patients aged 18 years or older, both male and female, in preoperative period to elective cardiac surgery and with extracorporeal circulation were included; diagnosed patients with cognitive and/or psychiatric disorders, neuromuscular and/or orthopedic diseases that affect their independent mobility, as well as with missing data on medical records were excluded. The following independent variables were analyzed: preoperative factors, intraoperative factors and postoperative factors. The Functional Status Score for the Intensive Care Unit (FSS-ICU), at intensive care unit (ICU) and hospital discharge, as well as gait speed at ICU discharge, were the dependent variables. Data were collected through electronic medical records, calls and application of gait speed test at ICU discharge, between October 2021 and October 2022. Results – A total of 116 participants were included, of which 62 were monitored for a 6 months period. Sample showed a mean age of 54.7 years (± 13.9 years), 58 (50%) were male, predominant type of surgery was isolated coronary artery bypass graft surgery in 43 patients (43.1%). In single analyzes for each variable, there was a significant association between gait speed and drains use , presence of postoperative complications and stay hospitalization in the ICU (p<0.05). In the analysis of variables jointly, only drains use remained significant (p<0.05). A weak positive correlation was identified between stay hospitalization between ICU discharge and hospital discharge with the FSS-ICU at hospital discharge (r = 0.31, p= 0.001). Conclusion – In relation to the sample, patients undergoing postoperative period of cardiac surgery, a weak negative correlation was identified between the number of days of drains use and gait speed at ICU discharge. In addition, stay hospitalization between ICU discharge and hospital discharge showed a weak positive correlation with functional status at hospital discharge.