Muscle strength trajectories and their association with postoperative health-related quality of life in patients undergoing coronary artery bypass grafting surgery: a prospective cohort study

BMC Cardiovascular Disorders

Research

Pim van der Harst¹  Sandra Dijkstra²  Massimo A. Mariani²  Johanneke Hartog²  Fredrike Blokzijl³  Maarten Nijsten⁴  Willem Dieperink⁵  Joke Fleer⁶  Trynke Hoekstra⁷  Lucas H. V. van der Woude⁸ 

[1] Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands;Department of Cardiothoracic Surgery, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, AB41, 9713 GZ, Groningen, The Netherlands;Department of Cardiothoracic Surgery, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, AB41, 9713 GZ, Groningen, The Netherlands;Research Group Nursing Diagnostics, Hanze University of Applied Sciences, Groningen, The Netherlands;Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;Research Group Nursing Diagnostics, Hanze University of Applied Sciences, Groningen, The Netherlands;Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands;Department of Rehabilitation Medicine, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;

关键词: Cardiac surgical procedures;    Health status;    Quality of life;    Sarcopenia;    Muscular atrophy;    Muscle strength;    Muscle weakness;    Therapeutics;    Sex;   

DOI  :  10.1186/s12872-023-03056-7

 received in 2022-08-04, accepted in 2023-01-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPatients with sarcopenia have a higher risk of poor recovery after coronary artery bypass grafting (CABG). Little is known about the impact of changes in muscle strength (the primary indicator for sarcopenia) on health-related quality of life (HR-QoL). This study aimed to (1) identify subgroups with different muscle strength trajectories, (2) identify differences in preoperative risk factors among trajectory group membership, and (3) explore their prognostic value on postoperative HR-QoL in patients undergoing CABG.MethodsIn this prospective observational study 131 patients undergoing elective CABG completed grip strength tests and HR-QoL questionnaires. Latent Class Growth Mixture Modelling (LCGMM) was used to identify clinically relevant trajectories (> 5% of study population) for weight-normalised grip strength, measured at admission, 3 days, and 6 months after surgery. Differences between trajectory group membership at baseline were evaluated. The impact of trajectory group membership on postoperative HR-QoL was evaluated with multiple linear regression models.ResultsDue to low numbers (n = 15), female patients were excluded from LCGMM and subsequent statistical analyses. In males (n = 116), we identified two main weight-normalised grip strength trajectories: a “stable average” trajectory with a slight decline immediately post-surgery and recovery to preoperative levels (n = 85) and a “high” trajectory with a considerable immediate decline after surgery but followed towards a higher level of recovery compared to preoperative level (n = 27). The “stable average” patients were older (68 vs. 57 years; P = 0.003), had more diabetes (27% vs. 4%; P = 0.01) and had a higher BMI (27.8 vs. 24.8; P = 0.005) compared to the “high” group. After correction for age, diabetes, and baseline HR-QoL, group trajectory membership was not associated with postoperative HR-QoL, yet an increase in individual change scores of weight-normalised grip strength was associated with a better postoperative HR-QoL. We also identified one small trajectory group (n = 4, ≤ 5%).ConclusionsThis study showed two relevant weight-normalised grip strength trajectories in male patients undergoing CABG, varying in important preoperative risk factors. While change scores of grip strength per weight did predict postoperative HR-QoL, the trajectory subgroups could not predict postoperative HR-QoL. Future research should focus on female patients, reacting potentially different on CABG and/or rehabilitation treatment.Trial registration NCT03774342, 12-12-2018.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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