Acute changes in handgrip strength, lung function and health-related quality of life following cardiac surgery.

Siva Senthuran,Nnamdi Mgbemena,Nicholas Ang,Anne Jones,Anthony Leicht,Pankaj Saxena

doi:10.1371/journal.pone.0263683

Abstract

BackgroundHandgrip strength (HGS), lung function and health-related quality of life (HRQoL) are relevant indicators of future cardiovascular risk and mortality. The impact of cardiac surgery on these predictive variables has been under-explored. The aim of this study was to determine the acute (within hospital) changes in HGS, lung function and HRQoL, and their relationships, in adults undergoing elective cardiac surgery. Further, the study examined the relationship between these variables and the predictors for lung function and HRQoL in these patients.MethodsThe study was a prospective cohort study that involved 101 patients who completed pre-operative (1–2 days before surgery) and physiotherapy discharge (5–7 days after surgery) assessments. Handgrip strength, lung function and HRQoL were assessed using JAMAR dynamometers, Vitalograph-Alpha or EasyOne spirometer, and Short-Form 36 questionnaire, respectively. Changes in these variables and their relationships were analysed using paired t-test and Pearson correlation coefficients, respectively. Prediction of lung function and HRQoL using HGS and other co-variates was conducted using regression analysis.ResultsAt the time of physiotherapy discharge, lung function, HGS and the physical component of HRQoL were significantly (<0.001) reduced compared to their pre-operative values. Significant (<0.001) and moderate correlations were identified between HGS and lung function at pre-operation and physiotherapy discharge. Handgrip strength was a significant predictor of lung function pre-operatively but not at physiotherapy discharge. Pre-operative lung function and HRQoL, as well as other variables, were significant predictors of lung function and HRQoL during physiotherapy discharge.ConclusionsUndergoing cardiac surgery acutely and significantly reduced lung function, HGS and physical component of HRQoL in adults with cardiac disease. Assessment of HGS at physiotherapy discharge may be a poor indicator of operative changes in lung function and HRQoL. Clinicians may consider HGS as an inadequate tool in predicting lung function and HRQoL following cardiac surgery.

Highlights

Cardiac diseases are the single, largest cause of death in the general population and have become a global public health concern [1] with cardiac surgery a primary treatment for cardiac disease management [2]
Significant (
Handgrip strength was a significant predictor of lung function pre-operatively but not at physiotherapy discharge

Summary

Introduction

Cardiac diseases are the single, largest cause of death in the general population and have become a global public health concern [1] with cardiac surgery a primary treatment for cardiac disease management [2]. Following cardiac surgery there are variable changes in important indicators of musculoskeletal and cardiorespiratory function such as handgrip strength (HGS) and lung function/efficiency [3–6], most likely due to inflammation [7, 8]. This inflammatory deconditioning may lead to a concomitant decrease in health-related quality of life (HRQoL) for patients [3] with reduced HRQoL predictive of future cardiac disease risk and/or related deaths [9]. Previous studies that investigated the acute impact of cardiac surgery on lung function reported marked reductions at two [13] and four [5] days following surgery with no study reported at the point of physiotherapy discharge from the hospital. The study examined the relationship between these variables and the predictors for lung function and HRQoL in these patients

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