The 6-minute walking test and all-cause mortality in patients undergoing a post-cardiac surgery rehabilitation program

Maria Teresa La Rovere, Gian Domenico Pinna, Roberto Maestri, Francesca Olmetti, Vincenzo Paganini, Giorgio Riccardi, Roberto Riccardi, Claudio Goggi, Marco Ranucci, Oreste Febo

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: 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. Design and 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 6mWTwas 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.

Original languageEnglish
Pages (from-to)20-26
Number of pages7
JournalEuropean Journal of Preventive Cardiology
Volume22
Issue number1
DOIs
Publication statusPublished - Jan 19 2015

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Thoracic Surgery
Walking
Mortality
Stroke Volume
Cardiac Rehabilitation
Patient Discharge
Serum Albumin
Rehabilitation
Multivariate Analysis
Exercise
Weights and Measures

Keywords

  • 6-minute walking test
  • Cardiac rehabilitation
  • Cardiac surgery
  • Functional capacity
  • Left ventricular ejection fraction
  • Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Epidemiology
  • Medicine(all)

Cite this

The 6-minute walking test and all-cause mortality in patients undergoing a post-cardiac surgery rehabilitation program. / La Rovere, Maria Teresa; Pinna, Gian Domenico; Maestri, Roberto; Olmetti, Francesca; Paganini, Vincenzo; Riccardi, Giorgio; Riccardi, Roberto; Goggi, Claudio; Ranucci, Marco; Febo, Oreste.

In: European Journal of Preventive Cardiology, Vol. 22, No. 1, 19.01.2015, p. 20-26.

Research output: Contribution to journalArticle

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AU - La Rovere, Maria Teresa

AU - Pinna, Gian Domenico

AU - Maestri, Roberto

AU - Olmetti, Francesca

AU - Paganini, Vincenzo

AU - Riccardi, Giorgio

AU - Riccardi, Roberto

AU - Goggi, Claudio

AU - Ranucci, Marco

AU - Febo, Oreste

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N2 - Background: 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. Design and 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 6mWTwas 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.

AB - Background: 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. Design and 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 6mWTwas 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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KW - Left ventricular ejection fraction

KW - Mortality

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