Academic Editors: Kazuhiro P. Izawa and Peter H. Brubaker
Background: Following cardiovascular surgery, patients are at high risk of
requiring systemic management in the intensive care unit (ICU), resulting in
hospitalization-associated disability (HAD). Predicting the risk of HAD during
the postoperative course is important to prevent susceptibility to cardiovascular
events. Assessment of physical function during the ICU stay may be useful as a
prediction index but has not been established. Methods: This prospective
observational study conducted at a high-volume cardiovascular center included 236
patients (34% female; median age, 73 years) who required an ICU stay of at least
72 hours after surgery and underwent postoperative rehabilitation. HAD was
defined as a decrease in the discharge Barthel index (BI) score of at least 5
points relative to the preadmission BI score. Physical Function ICU Test-scored
(PFIT-s), Functional Status Score for the ICU (FSS-ICU), and Medical Research
Council (MRC)-sumscore were used to assess physical function at ICU discharge.
Results: HAD occurred in 58 (24.6%) of the 236 patients following cardiovascular
surgery. The cut-off points for HAD were 7.5 points for the PFIT-s (sensitivity
0.80, specificity 0.59), 24.5 points for the FSS-ICU (sensitivity 0.57,
specificity 0.66), and 59.5 points for the MRC-sumscore (sensitivity 0.93,
specificity 0.66). Multivariate logistic regression analysis revealed a PFIT-s of