Heart Surgery Stems Increased Nutritional Risk, Expressed during the Course of Stationary Rehabilitation

Abstract

Background: Cardiovascular diseases are a vast global health burden. Despite common prevalence, current knowledge and investigations concerning nutritional aspects are limited. Characteristics and dynamics of nutritional risk are not entirely known for most of the entities, disease stages or treatment-induced fluctuations. This study assessed the effects of heart surgery on unintentional weight loss and nutritional risk using the NRS-2002. Methods: A noninterventional study that included patients scheduled for rehabilitation 1-6 months after heart surgery was performed. Evaluation included routine cardiovascular diagnostics and review of medical histories. Documented baseline weight was available for >85% of the patients. Nutritional risk screening was performed with the standardized NRS-2002 questionnaire. Results: A total of 145 patients were involved, with a mean age of 65.3 ± 11.5 years in a range of 23-84 years. The male to female ratio was 121:24 (83.4%:16.6%), respectively. Coronary artery bypass graft surgery (CABG) was performed in 89 patients (61.4%), valvular surgery (VS) in 34 (23.4%) and combined operations (CABG + VS) in 22 (15.2%). Percentage weight loss history was 11.1 ± 3.4% in a range of 0-20.1%, while NRS-2002 was 4.77 ± 1.05 in a range of 1-6. Increased nutritional risk (NRS-2002 ≥3) was found in nearly all patients. Combined ischemic and valvular etiology displayed the highest values of NRS-2002 (5.0 ± 1.2). Patient age and creatinine showed significant correlations with NRS-2002 (Rho = 0.521, p < 0.001 and Rho = 0.335, p < 0.001, respectively). Conclusion: Increased nutritional risk was found to be frequently prevalent in patients scheduled for rehabilitation after heart surgery. Risk was found to be in relation with underlying coronary artery disease as well as with the age of patients and parameters of renal function. Routine application of nutritional risk screening appears to be a valuable clinical tool for detecting this relevant comorbidity, particularly since no connection was found with traditional anthropometrics.

Nutritional Considerations of Cardiovascular Diseases and Treatments

“…Recognizing nutritional risk by routine application of nutritional risk scores improves patient evaluation. 53,137 Suboptimal nutrition status before cardiovascular surgery has been related not only to increased morbidity and prolonged hospital stay but also to delay of postoperative rehabilitation. 135,138 According to Arai et al, 139 who classified patients in 2 groups according to GNRI, patients in good nutrition group had earlier progression to walking after postoperative rehabilitation, higher rate of discharge home, and shorter postoperative hospitalization.…”

Food and heart—the nutritional jungle: Patients’ experiences of dietary habits and nutritional counselling after coronary artery bypass grafting

“…Eating ensure healing, general recovery and muscle strength -and improve the overall recovery (Desborough, 2000;Kondracki, 2012;Racca et al, 2010). Unfortunately, studies show that patients undergoing CABG experience reduced appetite after surgery (Bratt, Thylefors, & Jensen, 2017) causing unintentional weight loss and leading to reduced muscle strength and fatigue (Boban, Persic, Miletic, Kovacicek, & Madzar, 2013; DiMaria-Ghalili, Sullivan-Marx, & Compher, 2014).…”

Effects and Tolerance of Protein and Energy‐Enriched Formula in Infants Following Congenital Heart Surgery: A Randomized Controlled Trial

“…3 Congenital heart surgery using cardiopulmonary bypass is accompanied by a significant degree of hypermetabolism, hypometabolism, and an increase in energy and protein requirements. 4 Furthermore, given the limited reserves of energy and protein due to lower percentages of muscle mass and fat and higher resting energy expenditure, infants are particularly susceptible to nutrition-related problems. 5 Hence, postoperative nutrition support is an important aspect of clinical management for patients in the pediatric cardiac ICU (CICU) following surgical repair.…”

“…7 On the other hand, an excessive energy delivery can lead to metabolic overload, with increased production of carbon dioxide and prolongation of mechanical ventilation. 4 Therefore, the goal of this double-blind and randomized study was to compare nutrition effects and tolerance of the 2 different formulas (PE-formula vs S-formula) in infants after congenital heart surgery.…”