Effects of malnutrition on long-term survival in adult patients after elective cardiac surgery

Sergey M. Efremov, Tatiana I. Ionova, Tatiana P. Nikitina, Pavel E. Vedernikov, Timur A. Dzhumatov, Timofey S. Ovchinnikov, Abduvahhob A. Rashidov, Christian Stoppe, Daren K. Heyland, Vladimir V. Lomivorotov

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1 Citation (Scopus)

Abstract

Objectives: The aim of this study was to investigate the relationship between malnutrition and long-term survival in patients who underwent cardiopulmonary bypass (CPB). Methods: This study analyzed the long-term survival data of a mixed cohort of 1187 cardiac patients previously enrolled in a prospective observational study of nutritional screening in cardiac surgery. Nutritional status was assessed using the Malnutrition Universal Screening Tool (MUST). The mean age of patients was 58.86 ± 10.07 y (95% confidence interval [CI], 58.2–59.4). The median time of follow-up was 73.4 mo (25th–75th percentiles, 18.3–101.3). Results: In all, 449 patients (37.8%) were lost to follow-up after hospitalization. For the remaining participants, the overall 8-y survival was 68% (95% CI, 59–76) and 77% (95% CI, 73–80; log-rank, P = 0.12) in patients with and without malnutrition risk, respectively. Statistically significant differences in survival were found during the 3-y follow-up of patients with heart valve disease: 83% (95% CI, 74–92) with malnutrition versus 93% (95% CI, 90–96) without malnutrition (log-rank, P = 0.03). The final multivariate Cox regression model revealed logistic EuroSCORE (hazard ratio (HR), 1.337; 95% CI, 1.110–1.612), cardiopulmonary bypass time <110.5 min (HR 0.463, 95% CI 0.255–0.842), preoperative albumin (HR 0.799, 95% CI 0.691–0.924), and C-reactive protein (HR, 1.106; 95% CI, 1.018–1.202) as independent predictors of 3-y survival. Conclusion: Preoperative malnutrition is not associated with 8-y mortality in a mixed cardiac surgery cohort. However, it may be associated with worse 3-y outcomes in patients with heart valve disease.

Original languageEnglish
Article number111057
JournalNutrition
Volume83
DOIs
Publication statusPublished - Mar 2021

Keywords

  • Albumin
  • Cardiac surgery
  • Malnutrition
  • Nutritional screening
  • Survival

OECD FOS+WOS

  • 3.03.SA NUTRITION & DIETETICS
  • 3.02.IA ENDOCRINOLOGY & METABOLISM

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