Six-Minute Walk Test as a Functional Discharge Marker in Post-Cardiothoracic Surgery Patients and Implications for Nurse Practitioner-Led Transitional Care

Cardiothoracic surgery is associated with significant physiological stress and transient functional impairment, necessitating careful evaluation of discharge readiness. While traditional discharge criteria emphasize hemodynamic stability and wound healing, functional capacity and physical endurance are often under- assessed. The six-minute walk test (6MWT) is a simple, low-cost, and validated measure of functional exercise capacity that reflects integrated cardiopulmonary and musculoskeletal function. This review synthesizes current evidence on the role of the six-minute walk test as a functional discharge marker in post- cardiothoracic surgery patients and examines implications for nursing and nurse practitioner-led transitional care. Functional readiness after cardiothoracic surgery is a multidimensional construct encompassing physical endurance, mobility, symptom tolerance, confidence, and ability to perform activities of daily living. Evidence suggests that 6MWT performance is associated with post-operative physical activity levels, rehabilitation participation, reduced complications, and lower readmission rates. Despite its established utility, routine use of the six-minute walk test at discharge remains limited, particularly in low- and middle-income countries. Nurses and nurse practitioners play a pivotal role in integrating functional assessment into discharge planning, coordinating rehabilitation services, and ensuring safe transitions from hospital to home. Incorporating the six-minute walk test into routine discharge evaluation may significantly enhance patient safety, recovery outcomes, and continuity of care following cardiothoracic surgery.