The influence of patient strength, aerobic capacity and body composition upon outcomes after coronary artery bypass grafting.
BACKGROUND
Physical activity, physical fitness and body habitus of patients may be important predictors of outcomes after cardiac surgery. This study sought to quantify physical fitness and determine whether components of fitness enhance the prediction of outcomes in a group of patients undergoing coronary artery bypass grafting.


METHODS
A group of 200 patients were evaluated prior to coronary artery bypass surgery. A Veterans Specific Activity Questionnaire (VSAQ) measured aerobic capacity. A grip dynamometer assessed strength. Skin-fold thickness was used to calculate percent body fat and lean body mass index. Patients were divided into low risk (0-2.5%) and high risk (>2.5%) groups based on the STS National Cardiac Surgery Database prediction of operative mortality.


RESULTS
Patients with both a high percent body fat and a low VSAQ were at higher risk for at least one serious complication (p<0.05) and a longer postoperative length of stay (p<0.05).


CONCLUSIONS
This study suggests: 1) An index of physical fitness can be obtained preoperatively in cardiac surgical patients; 2) This information aids in the prediction of operative risk.
Cook
J W
JW
Carolinas Heart Institute and The Sanger Clinic Charlotte, North Carolina 28203, USA. jwcook@compuserve.com
Pierson
L M
LM
Herbert
W G
WG
Norton
H J
HJ
Fedor
J M
JM
Kiebzak
G M
GM
Ramp
W K
WK
Robicsek
F
F
D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D001026:Coronary Artery Bypass / Q000379:methods / Q000401:mortality*; D003327:Coronary Disease / Q000503:physiopathology* / Q000601:surgery; D017079:Exercise Tolerance; D005260:Female; D018737:Hand Strength; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome