Skip to main content
Top
Published in: General Thoracic and Cardiovascular Surgery 11/2018

01-11-2018 | Original Article

Preoperative nutritional status is associated with progression of postoperative cardiac rehabilitation in patients undergoing cardiovascular surgery

Authors: Yasuhiro Arai, Toru Kimura, Yuki Takahashi, Takashi Hashimoto, Mamoru Arakawa, Homare Okamura

Published in: General Thoracic and Cardiovascular Surgery | Issue 11/2018

Login to get access

Abstract

Objective

Progression of cardiac rehabilitation after cardiovascular surgery can be affected by frailty. The nutritional status of the patient has been proposed as an indicator of frailty. In this study, we aimed to evaluate the influence of preoperative nutritional status on the progress of postoperative cardiac rehabilitation.

Methods

This study included 146 patients (82 males, 64 females, average age 71.9 ± 12.0 years) who underwent elective cardiovascular surgery. In-hospital mortality cases were excluded to focus on postoperative cardiac rehabilitation. We classified patients with a Geriatric Nutritional Risk Index of 92 or higher as the good nutrition group and those with a Geriatric Nutritional Risk Index less than 92 as the malnutrition group. Preoperative patient characteristics and postoperative cardiac rehabilitation progress were compared between the good nutrition (n = 93) and malnutrition (n = 53) groups.

Results

The patients in the good nutrition group had an earlier progression to walking after postoperative rehabilitation (p = 0.002), a shorter postoperative hospital stay (p = 0.004), and a higher rate of discharge home (p = 0.028) than those in the malnutrition group. Multivariable analysis demonstrated preoperative malnutrition to be an independent predictor for the day to 100 m walking (p = 0.010).

Conclusions

Preoperative nutritional status was associated with progression of postoperative cardiac rehabilitation.
Literature
1.
go back to reference Xue QL, Bandeen-Roche K, Varadhan R, Zhou J, Fried LP. Initial manifestations of frailty criteria and the development of frailty phenotype in the Women’s Health and aging Study II. J Gerontol A Biol Sci Med Sci. 2008;63:984–90.CrossRef Xue QL, Bandeen-Roche K, Varadhan R, Zhou J, Fried LP. Initial manifestations of frailty criteria and the development of frailty phenotype in the Women’s Health and aging Study II. J Gerontol A Biol Sci Med Sci. 2008;63:984–90.CrossRef
2.
go back to reference Wakabayashi H, Sashika H. Malnutrition is associated with poor rehabilitation outcome in elderly inpatients with hospital-associated deconditioning: a prospective cohort study. J Rehabil Med. 2014;46:277–82.CrossRef Wakabayashi H, Sashika H. Malnutrition is associated with poor rehabilitation outcome in elderly inpatients with hospital-associated deconditioning: a prospective cohort study. J Rehabil Med. 2014;46:277–82.CrossRef
3.
go back to reference Ikuta S, Miki C, Hatada T, Inoue Y, Araki T, Tanaka K, et al. Allogenic blood transfusion is an independent risk factor for infective complication after less invasive gastrointestinal surgery. Am J Surg. 2003;185:188–93.CrossRef Ikuta S, Miki C, Hatada T, Inoue Y, Araki T, Tanaka K, et al. Allogenic blood transfusion is an independent risk factor for infective complication after less invasive gastrointestinal surgery. Am J Surg. 2003;185:188–93.CrossRef
4.
go back to reference Lomivorotov VV, Efremov SM, Boboshko VA, Nikolaev DA, Vedernikov PE, Deryagin MN, et al. Prognostic value of nutritional screening tools for patients scheduled cardiac surgery. Interact Cardiovasc Thorac Surg. 2013;16:612–18.CrossRef Lomivorotov VV, Efremov SM, Boboshko VA, Nikolaev DA, Vedernikov PE, Deryagin MN, et al. Prognostic value of nutritional screening tools for patients scheduled cardiac surgery. Interact Cardiovasc Thorac Surg. 2013;16:612–18.CrossRef
5.
go back to reference Engleman DT, Admas DH, Byrne JG, Aranki SF, Collins JJ Jr, Couper GS, et al. Impact of body mass index and albumin on morbidity and mortality after cardiac surgery. J Thorac Cardiovasc Surg. 1999;118:866–73.CrossRef Engleman DT, Admas DH, Byrne JG, Aranki SF, Collins JJ Jr, Couper GS, et al. Impact of body mass index and albumin on morbidity and mortality after cardiac surgery. J Thorac Cardiovasc Surg. 1999;118:866–73.CrossRef
6.
go back to reference Ogawa M, Izawa KP, Satomi-Kobayashi S, Kitamura A, Ono R, Sakai Y, et al. Poor preoperative nutritional status is an important predictor of the retardation of rehabilitation after cardiac surgery in elderly cardiac patients. Aging Clin Exp Res. 2017;29:283–90.CrossRef Ogawa M, Izawa KP, Satomi-Kobayashi S, Kitamura A, Ono R, Sakai Y, et al. Poor preoperative nutritional status is an important predictor of the retardation of rehabilitation after cardiac surgery in elderly cardiac patients. Aging Clin Exp Res. 2017;29:283–90.CrossRef
7.
go back to reference Bouillanne O, Morineau G, Dupont C, Coulombel I, Vincent JP, Nicolis I, et al. Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients. Am J Clin Nutr. 2005;82:777–83.CrossRef Bouillanne O, Morineau G, Dupont C, Coulombel I, Vincent JP, Nicolis I, et al. Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients. Am J Clin Nutr. 2005;82:777–83.CrossRef
8.
go back to reference Yamada K, Furuya R, Takita T, Maruyama Y, Yamaguchi Y, Ohkawa S, et al. Simplified nutritional screening tools for patients on maintenance hemodialysis. Am J Clin Nutr. 2008;87:106–13.CrossRef Yamada K, Furuya R, Takita T, Maruyama Y, Yamaguchi Y, Ohkawa S, et al. Simplified nutritional screening tools for patients on maintenance hemodialysis. Am J Clin Nutr. 2008;87:106–13.CrossRef
9.
go back to reference Cereda E, Zagami A, Vanotti A, Piffer S, Pedrolli C. Geriatric nutritional risk index and overall-cause mortality prediction in institutionalized elderly: a 3-year survival analysis. Clin Nutr. 2008;27:717–23.CrossRef Cereda E, Zagami A, Vanotti A, Piffer S, Pedrolli C. Geriatric nutritional risk index and overall-cause mortality prediction in institutionalized elderly: a 3-year survival analysis. Clin Nutr. 2008;27:717–23.CrossRef
10.
go back to reference JCS Joint Working Group. Guidelines for rehabilitation in patients with cardiovascular disease (JCS 2012). Circ J. 2014;78:2022–93.CrossRef JCS Joint Working Group. Guidelines for rehabilitation in patients with cardiovascular disease (JCS 2012). Circ J. 2014;78:2022–93.CrossRef
11.
go back to reference Nashef SA, Roques F, Sharples LD, Nilsson J, Smith C, Goldstone AR, et al. EuroSCORE II. Eur J Cardiothorac Surg. 2012;41:734–44.CrossRef Nashef SA, Roques F, Sharples LD, Nilsson J, Smith C, Goldstone AR, et al. EuroSCORE II. Eur J Cardiothorac Surg. 2012;41:734–44.CrossRef
12.
go back to reference Motomura N, Miyata H, Tsukihara H, Takamoto S. Risk model of thoracic aortic surgery in 4707 cases from a nationwide single-race population through a web-based data entry system: the first report of 30-day and 30-day operative outcome risk models for thoracic aortic surgery. Circulation. 2008;118:153–9.CrossRef Motomura N, Miyata H, Tsukihara H, Takamoto S. Risk model of thoracic aortic surgery in 4707 cases from a nationwide single-race population through a web-based data entry system: the first report of 30-day and 30-day operative outcome risk models for thoracic aortic surgery. Circulation. 2008;118:153–9.CrossRef
13.
go back to reference Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;2:1–138.CrossRef Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;2:1–138.CrossRef
14.
go back to reference Karas PL, Goh SL, Dhital K. Is low serum albumin associated with postoperative complications in patients undergoing cardiac surgery? Interact Cardiovasc Thorac Surg. 2015;21:777–86.PubMed Karas PL, Goh SL, Dhital K. Is low serum albumin associated with postoperative complications in patients undergoing cardiac surgery? Interact Cardiovasc Thorac Surg. 2015;21:777–86.PubMed
15.
go back to reference Nochioka K, Sakata Y, Takahashi J, Miyata S, Miura M, Takada T, et al. Prognostic impact of nutritional status in asymptomatic patients with cardiac diseases: a report from the CHART-2 study. Circ J. 2013;77:2318–26.CrossRef Nochioka K, Sakata Y, Takahashi J, Miyata S, Miura M, Takada T, et al. Prognostic impact of nutritional status in asymptomatic patients with cardiac diseases: a report from the CHART-2 study. Circ J. 2013;77:2318–26.CrossRef
16.
go back to reference Izawa KP, Watanabe S, Hirano Y, Yamamoto S, Oka K, Suzuki N, et al. The relation between Geriatric Nutritional Risk Index and muscle mass, muscle strength, and exercise capacity in chronic heart failure patients. Int J Cardiol. 2014;177:1140–41.CrossRef Izawa KP, Watanabe S, Hirano Y, Yamamoto S, Oka K, Suzuki N, et al. The relation between Geriatric Nutritional Risk Index and muscle mass, muscle strength, and exercise capacity in chronic heart failure patients. Int J Cardiol. 2014;177:1140–41.CrossRef
17.
go back to reference Kinugasa Y, Kato M, Sugihara S, Hirai M, Yamada K, Yanagihara K, et al. Geriatric nutritional risk index predicts functional dependency and mortality in patients with heart failure with preserved ejection fraction. Circ J. 2013;77:705–11.CrossRef Kinugasa Y, Kato M, Sugihara S, Hirai M, Yamada K, Yanagihara K, et al. Geriatric nutritional risk index predicts functional dependency and mortality in patients with heart failure with preserved ejection fraction. Circ J. 2013;77:705–11.CrossRef
18.
go back to reference Fearon KC, Ljungqvist O, Von Meyenfeldt M, Revhaug A, Dejong CH, Lassen K, et al. Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection. Clin Nutr. 2005;24:466–77.CrossRef Fearon KC, Ljungqvist O, Von Meyenfeldt M, Revhaug A, Dejong CH, Lassen K, et al. Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection. Clin Nutr. 2005;24:466–77.CrossRef
19.
go back to reference Weimann A, Braga M, Harsanyi L, Laviano A, Ljungqvist O, Soeters P, et al. ESPEN guidelines on enteral nutrition: surgery including organ transplantation. Clin Nutr. 2006;25:224–44.CrossRef Weimann A, Braga M, Harsanyi L, Laviano A, Ljungqvist O, Soeters P, et al. ESPEN guidelines on enteral nutrition: surgery including organ transplantation. Clin Nutr. 2006;25:224–44.CrossRef
20.
go back to reference Cerantola Y, Hubner M, Grass F, Demartines N, Schafer M. Immunonutrition in gastrointestinal surgery. Br J Surg. 2011;98:37–48.CrossRef Cerantola Y, Hubner M, Grass F, Demartines N, Schafer M. Immunonutrition in gastrointestinal surgery. Br J Surg. 2011;98:37–48.CrossRef
Metadata
Title
Preoperative nutritional status is associated with progression of postoperative cardiac rehabilitation in patients undergoing cardiovascular surgery
Authors
Yasuhiro Arai
Toru Kimura
Yuki Takahashi
Takashi Hashimoto
Mamoru Arakawa
Homare Okamura
Publication date
01-11-2018
Publisher
Springer Japan
Published in
General Thoracic and Cardiovascular Surgery / Issue 11/2018
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-018-0961-7

Other articles of this Issue 11/2018

General Thoracic and Cardiovascular Surgery 11/2018 Go to the issue