Abstract P215: Decreased Pre-Operative Risks and Increased Post-Operative Mental Functioning as Benefits of Regular Physical Activity for Patients Undergoing Cardiac Surgery

Abstract

Background: Regular exercise is a known primary and secondary defense against cardiovascular disease. Additionally, the American Heart Association has shown that regular exercisers have a decreased physiological response to stress, exhibit less anxiety and depression, and have better self-esteem. Objective: To examine the pre-operative risk factors and post-operative course of recovery for regular exercisers in cardiac surgery patients. Methods: A review was done of patient generated history forms and medical data for 281 patients that underwent isolated CABG at our institution since 2007. Only 166 patients had complete history forms: 98 patients were determined to be regular exercisers prior to CABG surgery, compared to 68 non-exercisers. A subset of patients (64 exercisers and 44 non-exercisers) also completed the SF-12 to measure health related quality of life (HRQL) at baseline and 12 months post-operatively. Results: Analyses found that the regular exercisers presented with better pre-operative risk factors than the sedentary patients, including lower BMI (t=2.6, p<0.02), lower STS morbidity/mortality risk score (t=3.3, p<0.003), lower logEuroScore (t=1.9, p=0.058), and fewer patients with diabetes (OR=0.47, p<0.04). The regular exercise group was also less likely to report depression (6% vs. 16%; Chi-square = 4.2, p<0.04) and presented with a higher physical composite HRQL at baseline than the non-exercisers (t=-3.6, p<0.001). Post-operative HRQL scores indicated that while both groups increased significantly from baseline to 12 months on physical composite scores, only the regular exercisers significantly improved on the mental composite scores (t=2.2, p<0.04). Conclusion: The importance and overall cost-benefit of regular physical activity can not be overemphasized. Regular exercisers have been shown to be at reduced risk for an adverse cardiac event. For those that must undergo cardiac surgery, the physically active present with reduced pre-operative risk and superior physical HRQL. Regular exercisers also experience greater post-operative improvements in mental HRQL as compared to their sedentary peers.