Trajectory of postoperative fatigue development in patients with coronary artery bypass grafts and its influence factors
Objective To explore the trajectory of postoperative fatigue development in patients undergoing coro-nary artery bypass grafting and its influencing factors.Methods A total of 145 patients who underwent coronary ar-tery bypass grafting(CABG)at the department of cardiac surgery of the Affiliated Hospital of Jining Medical Uni-versity from October 2022 to August 2023 were selected as survey respondents using the convenience sampling meth-od.In the follow-up procedure 21 cases to withdraw from the study,and 124 patients finally completed 4 surveys.The general data questionnaire,the Chinese version of multidimensional fatigue inventory-20(MFI-20),and the Bar-thel index rating scale were used to carry out a tracking investigation for patients'postoperative fatigue levels on the day before discharge and at 1,2,and 4 months after discharge,respectively,with the use of the latent category growth model(LCGM)to identify potential postoperative fatigue trajectory categories,and multiclassified logistic regression to analyze the factors that influenced the postoperative fatigue trajectory categories of the patients.Results The postoperative fatigue scores of patients showed a decreasing trend over time(F=310.039,P＜0.001),and MFI-20 scores decreased from(58.44±8.65)points on the 1 day before discharge to(36.92±9.89)points in 4 months after discharge;Finally,3 postoperative fatigue trajectory categories were identified,which were named ac-cording to their characteristics as moderate to mildly significant decline group,moderately slow decline group,and severe to moderate slow decline group,accounting for 53.2％,32.3％,and 14.5％,respectively.Univariate analy-sis showed that history of myocardial infarction,history of stroke,NYHA cardiac function classification,postopera-tive ICU stay days,postoperative left ventricular ejection fraction(LVEF),red blood cell count,hemoglobin,total cholesterol,low-density lipoprotein,and ability to perform activities of daily living were related to the category of postoperative fatigue trajectory(P＜0.05);Multifactorial logistic regression analysis showed that postoperative ICU stay days,history of myocardial infarction,NYHA cardiac function class,history of stroke,and ability to perform activities of daily living were the main influencing factors of postoperative fatigue trajectory categories in patients un-dergoing CABG(P＜0.05).Conclusion Heterogeneity exists in the postoperative fatigue development trajectory of CABG patients,and healthcare professionals should formulate targeted nursing measures according to the different trajectories of change,actively improve the controllable factors,and alleviate the patients postoperative fatigue level.
coronary artery bypass graftingfatiguelongitudinal studylatent class growth modelin-fluencing factorsnursing
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