Elucidation of factors related to mid- and long-term prognosis after cardiac surgery for the establishment of acute cardiac rehabilitation

• Project/Area Number: 17K01544
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Rehabilitation science/Welfare engineering
• Research Institution: Juntendo University (2019-2021); Hyogo University of Health Sciences (2017-2018)
• Principal Investigator: Morisawa Tomoyuki 順天堂大学, 保健医療学部, 准教授 (80552512)
• Co-Investigator(Kenkyū-buntansha): 高橋 哲也 順天堂大学, 保健医療学部, 教授 (00461179)
• Project Period (FY): 2017-04-01 – 2022-03-31
• Project Status: Completed (Fiscal Year 2021)
• Budget Amount: ¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000); Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2018: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2017: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
• Keywords: 高齢者 / 心臓外科 / 身体機能 / 予後 / リハビリテーション / 心臓外科手術 / フレイル / 予後調査 / 心臓リハビリテーション / 予後予測 / 多施設共同研究

Outline of Final Research Achievements

The incidence of hospitalization-associated functional decline (a condition in which physical function declines during hospitalization and does not recover to pre-hospital physical function)（HAFD） in elderly cardiac surgical patients was about 20%, an incidence comparable to that of other conditions. Prevention of HADF in elderly cardiac surgical patients is a strong independent factor for poor medium- and long-term prognosis, and prevention of HAFD should be a priority in the inpatient care of elderly cardiac surgical patients.
Female, chronic obstructive pulmonary disease, and delayed progress in postoperative rehabilitation were associated with the occurrence of HAFD, suggesting that identifying risk factors for HAFD as early as possible after admission and providing targeted, tailored care interventions may reduce the occurrence of HAFD.

Academic Significance and Societal Importance of the Research Achievements

これまでの先行研究で入院関連機能低下は高齢者の予後に関わる重要な因子であることは明らかにされているが、今回の研究の結果、高齢心臓外科患者においても予後を規定する重要な因子であることが明らかになった。本研究の結果は、高齢心臓外科患者の予後改善を目的とした新たな治療戦略を考える上で重要な資料になると思われる。

Research Products

• [Journal Article] Hospital-Acquired Functional Decline and Clinical Outcomes in Older Cardiac Surgical Patients: A Multicenter Prospective Cohort Study (2022)
  • Author(s): Tomoyuki Morisawa, Masakazu Saitoh, Shota Otsuka, Go Takamura, Masayuki Tahara, Yusuke Ochi, Yo Takahashi, kentaro iwata, Keisuke Oura, Koji Sakurada, Tetsuya Takahashi
  • Journal Title: Journal of Clinical Medicine Volume: 11 Issue: 3 Pages: 640-640
  • DOI: 10.3390/jcm11030640
  • Peer Reviewed / Open Access
• [Journal Article] Perioperative changes in physical performance affect short‐term outcome in elderly cardiac surgery patients (2021)
  • Author(s): Tomoyuki Morisawa, Masakazu Saitoh, Shota Otsuka, Go Takamura, Masayuki Tahara, Yusuke Ochi, Yo Takahashi, Kentaro Iwata, Keisuke Oura, Koji Sakurada, Tetsuya Takahashi
  • Journal Title: Geriatrics & Gerontology International Volume: 21 Issue: 8 Pages: 676-682
  • DOI: 10.1111/ggi.14227
  • Peer Reviewed
• [Journal Article] 高齢心臓手術後患者のリハビリテーション遅延が退院1年後の予後に及ぼす影響 (2021)
  • Author(s): 仲井佳祐、森沢知之、大塚翔太、内藤喜隆、松尾知洋、石原広大、平岡有努
  • Journal Title: 理学療法学 Volume: 48 Pages: 173-179
  • NAID: 130008027828
  • Peer Reviewed
• [Presentation] 高齢心臓外科患者の入院関連機能低下と予後の関連－多施設前向きコホート研究－ (2021)
  • Author(s): 森沢知之、齊藤正和、大塚翔太、高村剛、田原将之、越智裕介、高橋陽、大浦啓輔、岩田健太郎、櫻田弘治、高橋哲也
  • Organizer: 第69回日本心臓病学会学術集会
• [Presentation] 高齢心臓外科術後の入院中の身体的フレイルの回復の有無は短期予後に影響する (2020)
  • Author(s): 森沢知之、櫻田弘治、大塚翔太、高村剛、田原将之、越智裕介、高橋陽、大浦啓輔、岩田健太郎、高橋哲也
  • Organizer: 第84回日本循環器学会学術集会
• [Presentation] 高齢心臓外科患者の退院後の生活機能の変化と関連因子について (2019)
  • Author(s): 森沢知之、櫻田弘治、大塚翔太、高村剛、田原将之、越智裕介、高橋陽、大浦啓輔、岩田健太郎、高橋哲也
  • Organizer: 日本心臓リハビリテーション学会第4回関東甲信越支部地方会
• [Presentation] 心臓外科術後の中期予後に関わる要因の検討 (2018)
  • Author(s): 高橋哲也、森沢知之、大塚翔太、田原将之、大浦啓輔、越智祐介、高村剛、高橋陽、岩田健太郎
  • Organizer: 日本心臓リハビリテーション学会第3回関東甲信越支部地方会