Characterizaüon of the octogenarian patients submitted to cardiovascular surgery with physiotherapy interventions
DOI:
https://doi.org/10.24220/2318-0897v21n1/6a1870Keywords:
Postoperative complications, Physiotherapy, Aged, 80 and over, Cardiovascular surgical proceduresAbstract
Objective
To characterize the evolution of octogenarian patients undergoing cardiovascular surgery followed by physíotherapy interventions
Methods
This is a prospective and quantitative study developed from the information in the patients' medical records; the subjects were identified from the list of surgical patients and received follow-up until hospital discharge or until they deceased.
Results
A total of 50 patients were studied; the mean age was 82t2 years old, 64'’/o were men. Main preoperative conditions were hypertension (84%), smoking (36%), dyslipidemia (36%), and previous acute myocardial infarction (30%). The coronary
artery bypass graft was the most frequent surgical procedure (58c)/,). Of all patients in the study. one deceased during the transoperative period. 40 patients were successfully extubated (group without orotracheal reintubation) and 9 required reintubation (group with orotracheal reintubation). There was a high incidence of postoperatíve complications, particularly arrhythmia (44%), pneumonia and
pleural effusion (24Q/,), and delirium (24c)/,). The orotracheal reintubation group had lower left ventricular ejection fractÊon and the most frequent complications
pneumonia were (80%). arrhythmia (70%), pleural effusion (60c’/,) and deiirium (50'’/,), which increased duration of mechanical ventilation, length of stay in ICU, number of hospitalization days and mortality rate in this group in comparison
with the group without orotracheal reintubation (p<0.05). The patients received a larger number of physiotherapy sessions and non-invasive positive pressure
ventilatíon, particularly those with pulmonary and neurological complications (p<0 . 005).
Conclusion
Cardiac surgery in octogenarian patients, despite the prevalence of comorbidities, has positive results. The most significant postoperative complications were presented by those patients who required invasive ventilatory support, Although
postoperaüve cardiovascular complicaüons were frequently common, pulmonary and neurological complícatíons demanded more attention from the physiotherapy team.
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