Preoperative unintended weight loss and low body mass index in relation to complications and length of stay after cardiac surgery

BACKGROUND: Several studies reported increased adverse outcomes after cardiac surgery in patients with low body mass index (BMI; in kg/m²). Little is known yet, however, about the effect of preoperative unintended weight loss (UWL) in cardiac surgery patients. OBJECTIVE: We explored the prevalence a...

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Bibliographic Details
Published in:The American journal of clinical nutrition 2008-06, Vol.87 (6), p.1656-1661
Main Authors: Venrooij, Lenny MW van, Vos, Rien de, Borgmeijer-Hoelen, Mieke MMJ, Haaring, Cees, Mol, Bas AJM de
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Body Mass Index
cardiac surgery
Cardiac Surgical Procedures - adverse effects
Cohort Studies
complications
Coronary Artery Bypass - adverse effects
Feeding. Feeding behavior
Female
Fundamental and applied biological sciences. Psychology
heart diseases
Heart surgery
Heart Valves - surgery
Humans
Length of Stay
Male
Malnutrition - epidemiology
Middle Aged
Nutrition
nutrition assessment
nutritional status
patients
Postoperative Complications - epidemiology
Postoperative period
Preoperative Care
prospective cohort studies
Prospective Studies
Regression analysis
Reproducibility of Results
Studies
surgery
Treatment Outcome
Vertebrates: anatomy and physiology, studies on body, several organs or systems
Weight control
Weight Loss
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Summary:BACKGROUND: Several studies reported increased adverse outcomes after cardiac surgery in patients with low body mass index (BMI; in kg/m²). Little is known yet, however, about the effect of preoperative unintended weight loss (UWL) in cardiac surgery patients. OBJECTIVE: We explored the prevalence and effect of UWL in view of low BMI and vice versa adjusted for a validated set of preoperative risks, inflammatory activity, and duration of extracorporeal circulation on postoperative adverse outcome. DESIGN: A prospective cohort study was performed. Nutritional data of cardiac surgery patients were collected within 24 h of admission and linked to the standard postoperative complication registration database. RESULTS: The cohort consisted of 331 cases. Multivariate logistic regression analyses showed that preoperative UWL of >=10% in the past 6 mo (>=10%UWLin6m) was associated with a prolonged length of stay in the hospital independent from low BMI [odds ratio (OR): 7.06; 95% CI: 1.78, 28.04]. Preoperative BMI =10%UWLin6m (OR: 4.62; 95% CI: 1.20, 17.82; and OR: 5.27; 95% CI: 1.28, 21.76, respectively). Preoperative undernutrition in cardiac surgery patients (>=10%UWLin6m or BMI =10%UWLin6m or BMI
ISSN:0002-9165
1938-3207
DOI:10.1093/ajcn/87.6.1656