Is malnutrition associated with postoperative complications after cardiac surgery?


Journal

Journal of cardiac surgery
ISSN: 1540-8191
Titre abrégé: J Card Surg
Pays: United States
ID NLM: 8908809

Informations de publication

Date de publication:
Oct 2019
Historique:
pubmed: 4 7 2019
medline: 11 2 2020
entrez: 4 7 2019
Statut: ppublish

Résumé

Malnutrition is the central component of frailty that has an adverse influence on the prognosis of patients undergoing cardiac surgery. The relationship between malnutrition and postoperative complications was evaluated in a retrospective cohort study. In 287 patients undergoing elective cardiac surgery, nutritional status was assessed by using the Geriatric Nutritional Risk Index (GNRI). Then the patients were divided into a malnutrition group (GNRI <91) and a nonmalnutrition group (GNRI ≥91), after which the postoperative course was compared. There were 51 patients (17.8%) in the malnutrition group. Nine patients died after surgery and the operative mortality rate was significantly higher in the malnutrition group than the nonmalnutrition group (five deaths [9.8%] vs four deaths [1.8%]; P = .003). In addition, the duration of intensive care unit stay and hospital stay were both significantly longer in the malnutrition group compared with the nonmalnutrition group. Multivariate analysis showed that malnutrition was an independent predictor of hospitalization for longer than 1 month (odds ratio [OR]: 3.428; 95% confidence interval [CI]:1.687-6.964; P = .001) and a postoperative bedridden state (OR: 7.377; 95% CI:1.874-29.041; P = .004). Preoperative evaluation of the nutritional status using the GNRI seems to be valuable for predicting the risk of postoperative complications.

Sections du résumé

BACKGROUND AND AIM OBJECTIVE
Malnutrition is the central component of frailty that has an adverse influence on the prognosis of patients undergoing cardiac surgery. The relationship between malnutrition and postoperative complications was evaluated in a retrospective cohort study.
METHODS METHODS
In 287 patients undergoing elective cardiac surgery, nutritional status was assessed by using the Geriatric Nutritional Risk Index (GNRI). Then the patients were divided into a malnutrition group (GNRI <91) and a nonmalnutrition group (GNRI ≥91), after which the postoperative course was compared.
RESULTS RESULTS
There were 51 patients (17.8%) in the malnutrition group. Nine patients died after surgery and the operative mortality rate was significantly higher in the malnutrition group than the nonmalnutrition group (five deaths [9.8%] vs four deaths [1.8%]; P = .003). In addition, the duration of intensive care unit stay and hospital stay were both significantly longer in the malnutrition group compared with the nonmalnutrition group. Multivariate analysis showed that malnutrition was an independent predictor of hospitalization for longer than 1 month (odds ratio [OR]: 3.428; 95% confidence interval [CI]:1.687-6.964; P = .001) and a postoperative bedridden state (OR: 7.377; 95% CI:1.874-29.041; P = .004).
CONCLUSIONS CONCLUSIONS
Preoperative evaluation of the nutritional status using the GNRI seems to be valuable for predicting the risk of postoperative complications.

Identifiants

pubmed: 31269301
doi: 10.1111/jocs.14155
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

908-912

Informations de copyright

© 2019 Wiley Periodicals, Inc.

Auteurs

Satoshi Unosawa (S)

Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.

Makoto Taoka (M)

Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.

Shunji Osaka (S)

Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.

Daisuke Yuji (D)

Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.

Yoshiki Kitazumi (Y)

Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.

Keito Suzuki (K)

Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.

Keita Kamata (K)

Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.

Akira Sezai (A)

Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.

Masashi Tanaka (M)

Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.

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