• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2022.tde-03102022-085030
Document
Author
Full name
Verônica Borges Muniz da Silva
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2022
Supervisor
Committee
Rodrigues, Alfredo Jose (President)
Amaral, Livia Arcêncio do
Joviliano, Edwaldo Edner
Lima, Nereida Kilza da Costa
Title in Portuguese
Estratégias de avaliação da fragilidade pré-operatória em indivíduos submetidos à cirurgia cardíaca
Keywords in Portuguese
Cirurgia cardíaca
Comportamento sedentário
Estado funcional
Fragilidade
Velocidade de caminhada
Abstract in Portuguese
A síndrome da fragilidade leva a um estado de maior vulnerabilidade às situações adversas e desfechos desfavoráveis como morbidades, dependência e mortalidade.Ainda não há um consenso sobre qual a melhor forma ou método ideal de avaliação, principalmente se considerarmos as diferenças entre populações e validação entre os modelos utilizados. Nosso objetivo foi avaliar a presença de fragilidade pelos critérios propostos por Fried e verificar se os pacientes poderiam ser agrupados de acordo com as características clínicas associadas à fragilidade mediante outras formas de avaliação desses domínios, bem como evolução hospitalar pós-operatória. Os candidatos a cirurgias eletivas de revascularização do miocárdio (CRVM) e/ou troca valvar foram convidados a participar da pesquisa e a fragilidade foi avaliada pelos critérios propostos por Fried. Utilizamos também os questionários: Mini Avaliação Nutricional (MAN), Duke Activity Status Index (DASI), DutchExertion Fatigue Scale (DEFS), Patient Health Questionnaire-9 (PHQ-9) e avaliamos as pressões inspiratória e expiratória máximas. Foram incluídos122 pacientes, dentre esses 42 (14 mulheres e 28 homens) fizeram CRVM e 80 (41 mulheres e 39 homens) correções valvares, destes 34,4% (42) foram considerados frágeis, 56,6% (69)pré-frágeis e apenas 9% (11) não frágeis. A classificação com base nos critérios de Fried não mostrou diferença significativa nos desfechos avaliados no pós-operatório, entretanto na análise por Cluster, o Cluster 1 compreende a maioria dos pacientes considerados não frágeis e pré-frágeis (89,2%), e no Cluster 2, não há pacientes considerados não frágeis, sendo 65,1% considerados frágeis. A mortalidade (p=0,007) e proporção de eventos adversos foram significativamente maiores (p=0,004) no Cluster 2. Há alta prevalência de fragilidade e pré-fragilidade, tanto em idosos como não idosos e a proposta de uso de novos instrumentos para avaliar os domínios propostos por Fried parecem ser mais específicos para essa população.
Title in English
Strategies for assessing preoperative frailty in individuals undergoing cardiac surgery
Keywords in English
Cardiac surgery
Frailty
Functional status
Sedentary behavior
Walking speed
Abstract in English
The frailty syndrome leads to a state of greater vulnerability to adverse situations and unfavorable outcomes such as morbidities, dependence and mortality. There is still no consensus on the best form or ideal method of evaluation, especially if we consider the differences between populations and validation between the models used. Our objective was to assess the presence of frailty using the criteria proposed by Fried and to verify whether patients could be grouped according to the clinical characteristics associated with frailty using other forms of assessment of these domains, as well as postoperative hospital evolution. Candidates for elective coronary artery bypass graft surgery (CABG) and/or valve replacement were invited to participate in the research and frailty was assessed using the criteria proposed by Fried. We also used the following questionnaires: Mini Nutritional Assessment (MAN), Duke Activity Status Index (DASI), Dutch Exertion Fatigue Scale (DEFS), Patient Health Questionnaire-9 (PHQ-9) and we evaluated maximal inspiratory and expiratory pressures. A total of 122 patients were included, among these 42 (14 women and 28 men) underwent CABG and 80 (41 women and 39 men) underwent valvular correction, of which 34.4% (42) were considered frail, 56.6% (69) prefrail and only 9% (11) nonfrail. The classification based on Fried's criteria showed no significant difference in the outcomes evaluated in the postoperative period, however in the Cluster analysis, Cluster 1 comprises the majority of patients considered nonfrail and prefrail (89.2%), and in the Cluster 2, there are no patients considered nonfrail, with 65.1% considered frail. Mortality (p=0.007) and proportion of adverse events were significantly higher (p=0.004) in Cluster 2. There is a high prevalence of frailty and prefrailty, both in the elderly and in the non elderly and the proposal to use new instruments to assess the domains proposed by Fried seem to be more specific for this population.
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
Publishing Date
2022-11-01
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
CeTI-SC/STI
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2024. All rights reserved.