TY - JOUR

T1 - Effects of malnutrition on long-term survival in adult patients after elective cardiac surgery

AU - Efremov, Sergey M.

AU - Ionova, Tatiana I.

AU - Nikitina, Tatiana P.

AU - Vedernikov, Pavel E.

AU - Dzhumatov, Timur A.

AU - Ovchinnikov, Timofey S.

AU - Rashidov, Abduvahhob A.

AU - Stoppe, Christian

AU - Heyland, Daren K.

AU - Lomivorotov, Vladimir V.

N1 - Funding Information: The authors acknowledge Yury Fedotov, chief of Saint Petersburg State University Hospital, Alexander Karaskov, former chief of E. Meshalkin National Medical Research Center, and Alexander Chernyavsky, chief of E. Meshalkin National Medical Research Center for their general support of this study. Publisher Copyright: © 2020 Elsevier Inc. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2021/3

Y1 - 2021/3

N2 - 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.

AB - 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.

KW - Albumin

KW - Cardiac surgery

KW - Malnutrition

KW - Nutritional screening

KW - Survival

KW - SCREENING TOOL

KW - BODY-MASS INDEX

KW - NUTRITION

KW - ALBUMIN

KW - UNDERNUTRITION

UR - http://www.scopus.com/inward/record.url?scp=85099511557&partnerID=8YFLogxK

UR - https://www.mendeley.com/catalogue/b23c3303-53cc-3b24-9576-192d0c59c600/

U2 - 10.1016/j.nut.2020.111057

DO - 10.1016/j.nut.2020.111057

M3 - Article

AN - SCOPUS:85099511557

VL - 83

JO - Nutrition

JF - Nutrition

SN - 0899-9007

M1 - 111057

ER -