The Impact of Functional Status Assessed by the Barthel Index on Postoperative Outcomes in Patients Undergoing Cardiac Surgery: A Retrospective Cohort Study.

OBJECTIVES

To examine the impact of functional status assessed using the Barthel Index (BI) on acute kidney injury (AKI), intensive care unit (ICU) and hospital length of stay, and in-hospital mortality in patients undergoing cardiac surgery.

DESIGN

A retrospective cohort study.

SETTING

An academic hospital in China.

PARTICIPANTS

A total of 2,226 adults (mean age 60.3 ± 11.2 years; 58% male) undergoing cardiac surgery.

INTERVENTIONS: None

RESULTS

Compared to patients with BI ≥80, patients with BI <80 had increased risks of prolonged ICU stay (odds ratio [OR], 1.24; 95% confidence interval [CI], 1.00-1.55; p = 0.050) and hospital stay (OR, 1.28; 95% CI, 1.04-1.57; p = 0.019) in multivariable logistic regression models after adjusting for age-adjusted Charlson Comorbidity Index, sex, body mass index, surgical procedures, and duration of procedure. Although no significant association was detected between BI and AKI in the multivariable logistic regression model (OR, 1.05; 95% CI, 0.85-1.30; p = 0.660). Low BI was associated with an increased risk of 30-day in-hospital mortality in a multivariable Cox proportional hazards regression model (hazard ratio, 2.19; 95% CI, 1.35-3.53; p = 0.001).

CONCLUSIONS

Patients with low BI had significantly prolonged ICU and hospital stays, along with increased in-hospital mortality. Incorporating BI assessment into early screening protocols could facilitate the timely identification of high-risk patients, enabling personalized care strategies to improve outcomes.