Clinical Physiology of Circulation

ISSN 1814-6910 (Print)
ISSN 2410-9134 (Online)

 

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Issue's catalogue ➤ КФК. 2021; 18 (1): 1-92 ➤ Оценка психофизиологического резерва у пожилых пациентов перед операцией в условиях искусственного кровообращения

Assessment of the psychophysiological reserve in elderly patients before surgery under artificial circulation

Authors: Nikitina T.G., Pelekh D.M., Golukhova E.Z.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2021-18-1-73-8

UDC: 616.126-007-053.9:612.82

Link: Clinical Physiology of Blood Circulaiton. 2021; 1 (18): 73-83

Quote as: Nikitina T.G., Pelekh D.M., Golukhova E.Z. Assessment of the psychophysiological reserve in elderly patients before surgery under artificial circulation. Clinical Physiology of Circulation. 2021; 18 (1): 73–83 (in Russ.). DOI: 10.24022/1814-6910-2021-18-1-73-83

Keywords:  elderly patients artificial circulation valvular heart disease psychophysiological reserve comorbidity cognitive impairmen

Received / Accepted:  12.01.2021 / 14.01.2021

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Abstract

Objective: To analyze the EFI, CCI, SF-36 and SAGE questionnaires of elderly patients (≥ 60 years) with valvular heart disease (VHD) before surgical valve defects correction in order to assess the psychophysiological status.

Material and methods. In the Department of Cardiosurgery of Acquired Heart Diseases of the Bakoulev Center from January 2019 to June 2020 118 surgical VHD corrections in patients ≥ 60 years old were performed. The average age was 66 ± 3 years (60.2–74.9 years). 67 (56.8%) patients – in FC III according to NYHA, 51 (43.2%) – in IV FC. The average value of EuroSCORE II was 22.5 ± 1.6% (2.2–43.1%). The average artificial circulation time was 135 ± 2 minutes, the aortic clamping time was 41 ± 7.4 minutes. Hospital mortality was 7.6%. Before surgery, 118 patients underwent an assessment of their psychophysiological state using the EFI, CCI, SF-36 and SAGE questionnaires.

Results. The average score according to the EFI questionnaire was 8.9 ± 3.2, indicating that most of the patients (67%) admitted for VHD surgical treatment were vulnerable, mild frail, moderate frail and frail. Analyzing the results of the CCI questionnaire, we obtained an average score of 5 ± 3.6, which meant that, patients had ≥3 concomitant diseases and the 10-year life expectancy was 53%. According to the SF-36 questionnaire, a low quality of life was noted in terms of characteristics: physical functioning (44.3 ± 10.3), physical pain (50.9 ± 1.1), general health (56.3 ± 7.2). According to SAGE, 57.3% of our patients had no cognitive impairment.

Conclusion. The analysis of the EFI, CCI, SF-36, and SAGE questionnaires in 118 elderly patients showed that patients (67%) admitted for surgical treatment of VHD were vulnerable, mid frail, moderate frail, and frail and had a low quality of life and were highly comorbid. A multidisciplinary approach is needed in the selection and management of elderly patients before and after surgery with artificial circulation.

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About Authors

  • Tat’yana G. Nikitina, Dr. Med. Sc., Professor, Head of Department of Cardiology of Acquired Heat Defects; ORCID
  • Dmitriy M. Pelekh, Cand. Med. Sc., Researcher, Cardiologist; ORCID
  • Elena Z. Golukhova, Dr. Med. Sc., Professor, Academician of RAS, Director; ORCID

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