Department of Clinical Nutrition, Medical University of Gdańsk, 80-211 Gdańsk, Poland.
Department of Cardiac and Vascular Surgery, Medical University of Gdańsk, 80-211 Gdańsk, Poland.
Nutrients. 2019 Feb 20;11(2):446. doi: 10.3390/nu11020446.
There is still a lack of data on the nutritional status of older people with aortic stenosis (AS) and the effect of poor nutrition on the occurrence of complications and mortality after an aortic valve replacement (AVR) procedure. The aim of this study was to assess the impact of selected nutritional status parameters in elderly patients with severe AS on the occurrence of postoperative complications and one-year mortality after the AVR procedure. 101 elderly patients with AS aged 74.6 ± 5.2 years who qualified for surgical treatment (aortic valve area [AVA] 0.73 ± 0.2 cm²) were enrolled in the study. A nutritional status assessment was performed before AVR surgery, and the frequency of postoperative complications occurring within 30 days of surgery was assessed. The one-year mortality rate was also captured. Adverse events (both major and minor) up to 30 days occurred in 49.5% ( = 50) of the study population. Low Mini Nutritional Assessment (f-MNA) and Subjective Global Assessment (7-SGA) scores and low concentrations of total cholesterol, LDL-cholesterol, and prealbumin were associated with a higher risk of postoperative complications. The risk of complications increased 1.22 times (95% CI; 1.030⁻1.453; p = 0.019) with an impaired nutritional status. The annual mortality rate in the study group was 7.9%. Unintentional weight loss of >2.8% in the six months preceding surgery proved useful for predicting death within the first year after AVR surgery. The results indicate that poor nutritional status is an important factor affecting the adverse outcomes in elderly patients with severe aortic valve stenosis undergoing an AVR procedure.
老年人主动脉瓣狭窄(AS)的营养状况数据仍然缺乏,营养不良对主动脉瓣置换术(AVR)后并发症和死亡率的影响也不清楚。本研究旨在评估老年重度 AS 患者的某些营养状况参数对 AVR 术后并发症发生和一年死亡率的影响。
研究纳入了 101 名年龄 74.6±5.2 岁、符合手术治疗条件的老年 AS 患者(主动脉瓣口面积[AVA]为 0.73±0.2cm²)。在 AVR 术前进行了营养状况评估,并评估了术后 30 天内发生的并发症频率。还记录了一年的死亡率。
研究人群中有 49.5%(n=50)在 30 天内发生了不良事件(包括主要和次要不良事件)。低微型营养评估(f-MNA)和主观整体评估(7-SGA)评分以及总胆固醇、LDL-胆固醇和前白蛋白浓度低与术后并发症风险增加相关。营养状况受损时,并发症风险增加 1.22 倍(95%CI:1.030-1.453;p=0.019)。研究组的年死亡率为 7.9%。术前 6 个月内非故意体重减轻>2.8%可用于预测 AVR 术后 1 年内的死亡。
结果表明,营养状况差是影响行 AVR 术的老年重度主动脉瓣狭窄患者不良结局的重要因素。