Assessment of Physical Activity and Fitness in Cardiac Surgery Patients in Relation to Cognitive Function Decline and Perioperative Morbidity

Jaeggi, C.S.R. (2015) Assessment of Physical Activity and Fitness in Cardiac Surgery Patients in Relation to Cognitive Function Decline and Perioperative Morbidity. thesis, Medicine.

Text JaeggiCSR.pdf Restricted to Registered users only Download (401kB)

Abstract

Introduction Recently interest has grown in postoperative outcome. Because society is aging, it is important to make sure the elderly can stay independent. A complication of surgery that endangers this is post operative cognitive decline(POCD). A popular hypothesis for the origin of POCD is that immune priming leads to neuroinflammation. Recent studies have shown that exercise can improve the prognosis of chronic diseases and that exercise can have a positive effect on cognition. These effects might be caused by an anti-inflammatory effect of exercise. This interimanalysis of this pilotstudy executed by the department of anesthesiology will explore the relation between fitness and post-operative outcome. Materials and Methods For this study patients undergoing uncomplicated elective coronary bypass grafting surgery were included. Before, shortly after and three months after surgery fitnesslevels are measured by using the SQUASH-questionnaire, measuring handgripstrength and the get-up-and-go test. Subjects were divided into two groups(fit and unfit) using the Nederlandse Norm Gezond Bewegen(NNGB) according to the outcome of their SQUASH-questionnaire. Variables will be compared between the fit and unfit group. Demographics, surgery details, routine labwork and complications will be noted and patients will fill out the EQ5D questionnaire to evaluate their quality of life. Patients took the Cogstate digital battery to assess their cognition before and after surgery. The scores were compared to the patient's own baseline. Results At the time this paper was written, 78 patients had been approached to participate in this study, of which 62 patients had been included in the study and 32 patients had succesfully completed the study. Patients were 65 years of age and overweight on average. 91% of the population was male. 31 patients were deemed fit, 22 were deemed unfit according to the NNGB. There were no significant differences between groups in the collected data, except for a significantly higher CRP in the unfit group. The risks for surgical complications was not significantly different. Six patients developed POCD, all of which were fit. Conclusion More than half of the patients turned out to be classified as fit, mainly the patients who had already completed the study. This was more than originally expected. Except for a significantly higher CRP, there were no significant differences between the fit and unfit group. There was a minimal amount of unfit patients who had completed the study. This study was feasible, as long as there was more than one researcher. The continuation of this study will have to prove the value of the outcomes of this paper.

Item Type:	Thesis (Thesis)
Supervisor name:	Dagelijks begeleider: and Huet, Dr. R.C.G. and Facultair begeleider: and Absalom Prof. Dr. A.R. and Afdeling Anesthesiologie UMCG
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:40
Last Modified:	25 Jun 2020 10:40
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/201

Actions (login required)

View Item