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 (3): 181-256 ➤ Оценка психофункционального статуса пожилых пациентов до коррекции клапанных пороков сердца

Assessment of the psycho-functional status of elderly patients before correction of valvular heart disease

Authors: Pelekh D.M., Nikitina T.G., Gulyan K.S., Fadeev A.A., Golukhova E.Z.

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

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2021-18-3-212-221

UDC: 616.126-007-053.9:612.82

Link: Clinical Physiology of Blood Circulaiton. 2021; 3 (18): 212-221

Quote as: Pelekh D.M., Nikitina T.G., Gulyan K.S., Fadeev A.A., Golukhova E.Z. Assessment of the psycho-functional status of elderly patients before correction of valvular heart disease. Clinical Physiology of Circulation. 2021; 18 (3): 212–21 (in Russ.). DOI: 10.24022/1814-6910-2021-18-3-212-221

Keywords:  psycho-functional status deterioration comorbidity cognitive impairments quality of life

Received / Accepted:  23.05.2021 / 08.06.2021

Full text:  

Abstract

Objective. To conduct a preoperative assessment of the psychophysiological state (PFS) in elderly patients before correction of the valvular heart disease (VHD).

Material and methods. 272 patients, mean age 62 ± 11.7 years, before the correction of the VHD, a questionnaire was conducted using the questionnaire scales of PFS: EFI, CCI, SF-36 and SAGE. The patients were divided into 2 groups: 182 patients ≥ 60 years old (elderly group – I) and 90 patients < 60 years old (control group – II). In group I, patients before surgery were assigned to FC III according to NYHA 52.2% and FC IV 47.8%. Average EuroSCORE II (ES II) in the elderly 37.8 ± 4.4%. In group II, NYHA FC III included 61.2%, FC IV – 38.8% of patients, average ES II 11.6 ± 3.5%.

Results. EFI: 72.7% of elderly patients were vulnerable to frail. In the control group, 43.4% were vulnerable and mid frail, 3.3% were moderate frail. Average CCI score in the elderly group was 5.5 ± 3.9, patients had ≥ 3 concomitant diseases. In group II, average score on the CCI questionnaire 3.3 ± 1.4. For SF-36, the elderly group showed low quality of life (≤ 55 points) in the physical function, role physical function (RPF) and pain, while in the control group, low scores were obtained only in the RPF and pain categories. SAGE: 53.8% of patients in the elderly group did not reveal cognitive impairments, borderline and moderate impairments were noted in 45.7% of patients, in 1 (0.5%) patient severe cognitive impairments were revealed. In the control group, 78.3% of patients had no cognitive impairments, and 21.7% of patients had borderline and moderate cognitive impairments.

Conclusion. Elderly patients who were admitted to the clinic for VHD correction before surgery had a high risk of surgical treatment according to ES II, a low level of PFS compared with the control group (<60 years). Evaluation of PFS at the preoperative stage makes it possible to assess the risk of surgery in each patient and to develop measures for the prevention of postoperative complications, which will undoubtedly improve the results of surgical treatment of a severe category of elderly and old patients.

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About Authors

  • Dmitriy M. Pelekh, Cand. Med. Sci., Researcher, Cardiologist; ORCID
  • Tat’yana G. Nikitina, Dr. Med. Sci., Professor, Head of Department of Cardiology of Acquired Heart Diseases; ORCID
  • Knar S. Gulyan, Cand. Med. Sci., Cardiologist;
  • Aleksandr A. Fadeev, Cand. Tech. Sci., Head of Laboratory for the Application of Polymers in Cardiovascular Surgery; ORCID
  • Elena Z. Golukhova, Dr. Med. Sci., Professor, Academician of the Russian Academy of Sciences, Director; ORCID

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