Factors associated with functional disability or mortality after elective noncardiac surgery: a prospective cohort study.

• Material Type: 博士論文
• Title: Factors associated with functional disability or mortality after elective noncardiac surgery: a prospective cohort study.
• Author/Editor: Ida, Mitsuru; Naito, Yusuke; Tanaka, Yuu; Inoue, Satoki; Kawaguchi, Masahiko
• Author Heading: Ida, Mitsuru; Naito, Yusuke; Tanaka, Yuu; Inoue, Satoki; Kawaguchi, Masahiko
• Publication, Distribution, etc.: Springer Nature
• Publication Date: 2022-06
• Publication Date (W3CDTF): 2022-06
• Alternative Title: 術後機能障害の関連因子の検討 : 前向きコホート研究
• Periodical title: Canadian journal of anaesthesia
• No. or year of volume/issue: 69 6
• Volume: 69
• Issue: 6
• Pages: 704-714
• ISSN (Periodical Title): ISSN : 0832-610X
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2022-06-29
• Dissertation Number: 甲第844号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: nutrition assessment; patient-reported outcome measures; patient safety; perioperative medicine; perioperative period
• Target Audience: 一般
• Note (General): type:Thesis; Purpose: Preoperative prediction of functional status after surgery is essential when practicing patient-centered medicine. We aimed to evaluate the incidence and factors associated with postoperative functional disability or all-cause mortality. Secondarily, we sought to describe the trajectory of disability in this population. Methods: Adults aged ≥ 55 yr who underwent elective noncardiac surgery under general anesthesia in a tertiary care hospital were followed up one year after surgery. Pre- and intraoperative factors associated with a composite outcome of postoperative functional disability or all-cause mortality were assessed using a multiple logistic regression. The sequential changes in the 12-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0 score were described and stratified by surgical invasiveness. Results: Of the 2,921 patients included, 293 experienced postoperative functional disability (10.0%; 95% confidence interval [CI], 8.9 to 11.1) and 124 died (4.2%; 95% CI, 3.5 to 5.0). In a multiple regression model, the potentially modifiable risk factors, body mass index ≥ 30 kg·m-2 and poor preoperative nutritional status, were significantly associated with the primary composite outcome, as well as nonmodifiable factors such as age, preoperative comorbidities, and blood loss volume. Changes in the 12-item WHODAS 2.0 disability score varied between different levels of surgical invasiveness and types of surgery. Conclusion: Within one year after surgery, one in ten patients experienced postoperative functional disability and one in 20 died. We identified potentially modifiable factors (obesity, poor nutritional status) associated with these adverse outcomes. Study registration: University Hospital Medical Information Network (UMIN000021671); registered 31 December 2015.; 博士（医学）・甲第844号・令和4年6月29日; © Canadian Anesthesiologists' Society 2022.; This is a post-peer-review, pre-copyedit version of an article published in Canadian journal of anaesthesia. The final authenticated version is available online at: https://doi.org/10.1007/s12630-022-02247-8.; identifier:Canadian journal of anaesthesia Vol.69 No.6 p.704-714 (2022 Jun); identifier:0832610X; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/4065; identifier:Canadian journal of anaesthesia, 69(6): 704-714
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1007/s12630-022-02247-8
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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