See the published version of this article at BMC Geriatrics.
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Research article
Precision implementation of early ambulation in elderly patients underwent off-pump coronary artery bypass graft surgery: a randomized controlled clinical trial
Qi Tan
Intensive Care Unit (ICU), Department of Cardiac Surgery, Provincial Hospital Affiliated to Shandong University
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Geriatrics.
Background
Though early ambulation (EA) is associated with improved outcomes for post-operative patients, precision initiative on EA for elderly patients has rarely been reported. The aim of this study is to determine the safety and effectiveness of precision implementation of EA in elderly patients underwent off-pump coronary artery bypass graft (OPCABG) surgery.
Methods
We conducted a single-center, randomized and controlled clinical trial involving elderly patients(≥60 years) in who EA support was implemented after OPCABG surgery. Patients were randomly assigned to precision early ambulation (PEA) group or routine ambulation (Control) group. Innovatively referring age-predicted maximal heart rate (APMHR) and VO 2max was the highlight of PEA. The primary end-point was the postoperative length of stay in hospital (PLOS). The secondary end-point included 90-day mortality, laboratory test, length of stay in ICU, the incidence of multiple organ complications as well as post-traumatic stress disorder (PTSD).
Results
There were 178 patients were enrolled, with 89 patients assigned to receive PEA and 89 to receive control procedure. By intent-to-treat analysis, during PEA program, participants performed a much longer distance of ambulation on the third day ( P =0.000). Mild-to-moderate physical activity in PEA group ameliorates PLOS ( P =0.031), Time of first bowel ( P =0.000) and partial pressure O 2 ( P g =0.001). Additionally, patients in PEA group showed significantly lower incidence of PTSD than those in Control group ( P =0.000).
Conclusion
APMHR and VO 2max are valuable for target intensity and exercise formula. PEA after OPCAPG surgery is safe and reliable for elderly patients, which not only reduces the hospital stay but also improves patients’ postoperative functional status.
Keywords
Early ambulation, Physical rehabilitation, Enhanced recovery after surgery, cardiac surgery, elderly patients
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CURRENT STATUS: Published
Version 1
Posted 09 Jan, 2020
Published
On 14 Oct, 2020
Published
On 14 Oct, 2020
No community comments so far
Review #2 received
Received 10 May, 2020
Reviewer #2 agreed
On 13 Apr, 2020
Review #1 received
Received 13 Apr, 2020
Reviewer #1 agreed
On 29 Mar, 2020
Reviewers invited
Invitations sent on 26 Feb, 2020
Editor assigned
On 07 Jan, 2020
Editor invited
On 06 Jan, 2020
Submission checks complete
On 05 Jan, 2020
Editorial decision: Major revision
On 04 Jan, 2020
First submitted
On 02 Jan, 2020
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Subject Areas
Geriatrics & Gerontology
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This preprint is under consideration at BMC Geriatrics. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Precision implementation of early ambulation in elderly patients underwent off-pump coronary artery bypass graft surgery: a randomized controlled clinical trial
Qi Tan
Intensive Care Unit (ICU), Department of Cardiac Surgery, Provincial Hospital Affiliated to Shandong University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 1
Posted 09 Jan, 2020
Published
On 14 Oct, 2020
Published
On 14 Oct, 2020
No community comments so far
Review #2 received
Received 10 May, 2020
Reviewer #2 agreed
On 13 Apr, 2020
Review #1 received
Received 13 Apr, 2020
Reviewer #1 agreed
On 29 Mar, 2020
Reviewers invited
Invitations sent on 26 Feb, 2020
Editor assigned
On 07 Jan, 2020
Editor invited
On 06 Jan, 2020
Submission checks complete
On 05 Jan, 2020
Editorial decision: Major revision
On 04 Jan, 2020
First submitted
On 02 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Geriatrics & Gerontology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Geriatrics.
Background
Though early ambulation (EA) is associated with improved outcomes for post-operative patients, precision initiative on EA for elderly patients has rarely been reported. The aim of this study is to determine the safety and effectiveness of precision implementation of EA in elderly patients underwent off-pump coronary artery bypass graft (OPCABG) surgery.
Methods
We conducted a single-center, randomized and controlled clinical trial involving elderly patients(≥60 years) in who EA support was implemented after OPCABG surgery. Patients were randomly assigned to precision early ambulation (PEA) group or routine ambulation (Control) group. Innovatively referring age-predicted maximal heart rate (APMHR) and VO 2max was the highlight of PEA. The primary end-point was the postoperative length of stay in hospital (PLOS). The secondary end-point included 90-day mortality, laboratory test, length of stay in ICU, the incidence of multiple organ complications as well as post-traumatic stress disorder (PTSD).
Results
There were 178 patients were enrolled, with 89 patients assigned to receive PEA and 89 to receive control procedure. By intent-to-treat analysis, during PEA program, participants performed a much longer distance of ambulation on the third day ( P =0.000). Mild-to-moderate physical activity in PEA group ameliorates PLOS ( P =0.031), Time of first bowel ( P =0.000) and partial pressure O 2 ( P g =0.001). Additionally, patients in PEA group showed significantly lower incidence of PTSD than those in Control group ( P =0.000).
Conclusion
APMHR and VO 2max are valuable for target intensity and exercise formula. PEA after OPCAPG surgery is safe and reliable for elderly patients, which not only reduces the hospital stay but also improves patients’ postoperative functional status.
Figure 1
Figure 2