• Masaaki Sato, Hitoshi Mutai, Shuhei Yamamoto, Daichi Tsukakoshi, Shuhei Takeda, Natsuko Oguchi, Hajime Ichimura, Shota Ikegami, Yuko Wada, Tatsuichiro Seto, and Hiroshi Horiuchi.
• Division of Occupational Therapy, Shinshu University School of Health Sciences, Matsumoto, Japan.
• Medicine (Baltimore). 2021 Aug 6; 100 (31): e26819e26819.

AbstractRecently, activities of daily living (ADL) were identified as a prognostic factor among elderly patients with heart disease; however, a specific association between ADL and prognosis after cardiac and aortic surgery is not well established. We aimed to clarify the impact of ADL capacity at discharge on prognosis in elderly patients after cardiac and aortic surgery.This retrospective cohort study included 171 elderly patients who underwent open operation for cardiovascular disease in a single center (median age: 74 years; men: 70%). We used the Barthel Index (BI) as an indicator for ADL. Patients were classified into 2 groups according to the BI at discharge, indicating a high (BI ≥ 85) or low (BI < 85) ADL status. All-cause mortality and unplanned readmission events were observed after discharge.Thirteen all-cause mortality and 44 all-cause unplanned readmission events occurred during the median follow-up of 365 days. Using Kaplan-Meier analysis, a low ADL status was determined to be significantly associated with all-cause mortality and unplanned readmission. In the multivariable Cox proportional hazard models, a low ADL status was an independent predictor of all-cause mortality and unplanned readmission after adjusting for age, sex, length of hospital stay, and other variables (including preoperative status, surgical parameter, and postoperative course).A low ADL status at discharge predicted all-cause mortality and unplanned readmission in elderly patients after cardiac and aortic surgery. A comprehensive approach from the time of admission to postdischarge to improve ADL capacity in elderly patients undergoing cardiac and aortic surgery may improve patient outcomes.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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