The Effect of Inhibitory Factors on 100-m Independent Ambulation Immediately after Cardiovascular Surgery in Patients Aged ≥80 Years

Abstract

Purpose: This study aimed to identify factors associated with inhibition of independent ambulation and progression of rehabilitation after cardiovascular surgery in patients aged ≥80 years. Methods: This study involved 557 consecutive patients who underwent cardiovascular surgery (male: 278; mean age: 83.3 years) at 12 facilities in Japan. The patients were classified into 4 groups on the basis of the first postoperative day (POD) of 100-m independent ambulation: (1) early independence group (POD: ≤5), (2) favorable group (POD: 6–8), (3) delay group (POD: ≥9), and (4) non-independence group, and were assessed. Results: The number of patients in each group was as follows: early independence group, 271 (48.6%); favorable group, 104 (18.7%); delay group, 90 (16.2%); and non-independence group, 92 (16.5%). In all groups except the non-independence group, the mean time interval for independent ambulation was 7.0 days. Low ADL before cardiovascular surgery was the most important reason for delayed recovery and non-independence (32.4%). Multiple logistic analyses revealed that chronic kidney disease was significantly associated with delayed recovery. Conclusion: Even among very old patients, approximately 70% regained independent ambulation after cardiovascular surgery. Chronic kidney disease was a leading predictor of delayed recovery of physical activity after cardiovascular surgery.