Preoperative short physical performance battery as predictors of prolonged hospitalization after coronary artery bypass grafting in older patients: a prospective cohort study

Abstract

Background The short physical performance battery (SPPB) has played an important role in establishing a linkage between body function and health. Aims The aim of this study was to evaluate the predictive value of the SPPB summary score and its three components for screening prolonged hospitalization for coronary artery bypass grafting (CABG) in older patient candidates. Methods This study included 188 consecutive elderly patients (aged ≥ 60 years) undergoing elective CABG surgery and all the patients were assessed for SPPB. Stepwise regression was employed to analyze the association of postoperative length of hospital stay (LOS) with SPPB. The validity of SPPB scores were assessed by ROC curves to analyze the sensitivity and specificity for identifying elderly patients with prolonged hospitalization. ResultsAlthough SPPB and three components of SPPB all were independent risk factors of prolonged hospitalization, only the SPPB summary score and the 4-meter gait speed components showed good discriminative capabilities. A SPPB summary score cutoff of 10 provided the best accuracy for identifying prolonged hospitalization. The net benefit of model 2 (Model 1 combined with SPPB cut-off score) was better than that of the model 1 that had threshold probabilities of 30%–100%. Conclusions This study provided evidence for the clinical utility of the SPPB summary score and 4MGS test for prolonged hospitalization in elderly patients undergoing CABG. These tests also showed potential as a screening test for identifying elderly patients undergoing CABG who are at risk of prolonged hospitalization mobility.