Arai Yasuhiro, Kimura Toru, Takahashi Yuki, Hashimoto Takashi, Arakawa Mamoru, Okamura Homare
Department of Rehabilitation, Nerima Hikarigaoka Hospital, 2-11-1 Hikarigaoka Nerima-ku, Tokyo, 179-0072, Japan.
Department of Cardiovascular surgery, Nerima Hikarigaoka Hospital, 2-11-1 Hikarigaoka, Nerima-Ku, Tokyo, 179-0072, Japan.
Gen Thorac Cardiovasc Surg. 2018 Nov;66(11):632-640. doi: 10.1007/s11748-018-0961-7. Epub 2018 Jun 23.
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.
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.
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).
Preoperative nutritional status was associated with progression of postoperative cardiac rehabilitation.
心血管手术后心脏康复的进展可能会受到虚弱的影响。患者的营养状况已被提议作为虚弱的一个指标。在本研究中，我们旨在评估术前营养状况对术后心脏康复进展的影响。
本研究纳入了146例行择期心血管手术的患者（82例男性，64例女性，平均年龄71.9±12.0岁）。为聚焦于术后心脏康复，排除了院内死亡病例。我们将老年营养风险指数为92或更高的患者分类为营养良好组，将老年营养风险指数低于92的患者分类为营养不良组。比较了营养良好组（n = 93）和营养不良组（n = 53）的术前患者特征和术后心脏康复进展。
与营养不良组相比，营养良好组患者术后康复后开始行走的时间更早（p = 0.002），术后住院时间更短（p = 0.004），出院回家的比例更高（p = 0.028）。多变量分析表明术前营养不良是术后100米步行时间的独立预测因素（p = 0.010）。
术前营养状况与术后心脏康复的进展相关。
