Article

The 6-minute walking test (6mWT) is used to prescribe physical
activity in cardiac surgery patients. The clinical value of a pre-discharge 6mWT
and its association with outcome is not well defined. METHODS: We
retrospectively analyzed data from 313 patients (age 66 +/- 11 years, 23%
females, left ventricular ejection fraction (LVEF) 52 +/- 11%, Hb 10.5 +/- 1.3
g/dl, serum albumin 3.9 +/- 0.4 mg/dl) who were admitted to our rehabilitation
institute following cardiac surgery. A 6mWT was performed at entry and at
discharge and expressed as % of theoretical predicted values calculated on the
basis of individual age, height, weight and sex. The endpoint was represented by
all-cause mortality. The predictive value of 6mWT was tested in univariate and
multivariate analysis. RESULTS: A pre-discharge 6mWT was completed by 284 out of
313 patients. Two patients died in hospital. During a median of 23 months,
mortality was 9% (26/284) and 44% (12/27) (p < 0.0001) in patients who did or did
not perform the pre-discharge 6mWT. The distance covered at the pre-discharge
6mWT as a continuous variable of % predicted values was a significant predictor
of subsequent mortality (Hazard Ratio (HR) 0.97 (95% CI 0.96-0.99), p = 0.0019).
After adjustment for all preselected covariates, the pre-discharge 6mWT (HR 0.97
(95% CI 0.95-0.99), p = 0.0038) and LVEF (HR 0.93 (95% CI 0.90-0.96), p < 0.0001)
remained significantly associated with the outcome. CONCLUSIONS: In recent
cardiac surgery patients, the pre-discharge 6mWT is not only a valid measurement
of the impact of cardiac rehabilitation but also provides outcome information
offering the possibility to identify patients who may need more intensive
follow-up.
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Langue : ANGLAIS