Is malnutrition associated with postoperative complications after cardiac surgery?

J Card Surg. 2019 Oct;34(10):908-912. doi: 10.1111/jocs.14155. Epub 2019 Jul 3.

Abstract

Background and aim: 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: 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: 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: Preoperative evaluation of the nutritional status using the GNRI seems to be valuable for predicting the risk of postoperative complications.

Keywords: geriatric nutritional risk index; malnutrition; postoperative complications.

MeSH terms

  • Aged
  • Cardiac Surgical Procedures / adverse effects*
  • Elective Surgical Procedures / adverse effects*
  • Female
  • Hospital Mortality
  • Humans
  • Incidence
  • Japan / epidemiology
  • Male
  • Malnutrition / complications*
  • Malnutrition / epidemiology
  • Nutritional Status*
  • Odds Ratio
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology*
  • Prognosis
  • Retrospective Studies
  • Risk Assessment / methods*
  • Risk Factors
  • Survival Rate / trends