Predictive Role of Preoperative Nutritional Status on Early Postoperative Outcomes in Different-Aged Patients Undergoing Heart Valve Surgery

J Cardiothorac Vasc Anesth. 2024 May;38(5):1169-1180. doi: 10.1053/j.jvca.2024.01.037. Epub 2024 Feb 6.

Abstract

Objectives: The authors sought to elucidate the role and predictive effects of preoperative nutritional status on postoperative outcomes across different age groups undergoing heart valve surgery.

Design: A retrospective study with intergroup comparison, receiver operating characteristic curve analysis, and logistic regression analysis.

Setting: A hospital affiliated with a medical university.

Participants: Three thousand nine hundred five patients undergoing heart valve surgery between October 2016 and December 2020.

Interventions: None.

Measurements and main results: Patients were categorized into 3 age subgroups: young (aged 18-44 years), middle-aged (aged 45-59 years), and older (aged ≥60 years) adults. The Nutritional Risk Index (NRI), Prognostic Nutritional Index, and Controlling Nutritional Status scores were evaluated. Young adults with an NRI <99 experienced a significantly higher rate of prolonged intensive care unit stay (28.3% v 4.1%, p < 0.001), with a relative risk of 4.58 (95% CI: 2.04-10.27). Similarly, young adults with an NRI <97 had a significantly increased occurrence of mortality within 30 days after surgery (6.3% v 0.2%, p < 0.001), with a relative risk of 41.11 (95% CI: 3.19-529.48).

Conclusions: In patients who undergo heart valve surgery, early postoperative outcomes can be influenced by nutritional status before the surgery. In the young-adult group, NRI <99 and NRI <97 effectively could predict prolonged intensive care unit stay and 30-day mortality, respectively.

Keywords: early postoperative outcomes; heart valve surgery; nutritional risk index; nutritional status.

MeSH terms

  • Cardiac Surgical Procedures* / adverse effects
  • Heart Valves / surgery
  • Humans
  • Middle Aged
  • Nutritional Status*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Risk Factors