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单纯冠状动脉旁路移植术患者营养指标与长期预后的关系

Association Between Nutritional Indices and Long-Term Outcomes in Patients Undergoing Isolated Coronary Artery Bypass Grafting.

作者信息

Tasbulak Omer, Guler Arda, Duran Mustafa, Sahin Anil, Bulut Umit, Avci Yalcin, Demir Ali R, Kahraman Serkan, Aydin Unal, Ertürk Mehmet

机构信息

Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, TUR.

Cardiology, University of Health Sciences, Konya Training and Research Hospital, Konya, TUR.

出版信息

Cureus. 2021 Jul 22;13(7):e16567. doi: 10.7759/cureus.16567. eCollection 2021 Jul.

Abstract

Background It is well known that approximately 20% of patients who undergo cardiac surgery experience weight loss in postoperative period. However, there is a lack of data on postoperative consequences of malnutrition. This study aimed to investigate the relationship between nutritional status and long-term outcomes in patients undergoing isolated coronary artery bypass grafting (CABG). Material and methods A total of 586 patients who underwent isolated CABG in our center between January 2015 and March 2016 were included in this study. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE) defined as a composite of all-cause death, non-fatal myocardial infarction (MI), and stroke. Patients were divided into two groups based on their MACCE outcomes. Prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), and controlling nutritional status (CONUT) scores were used to show the nutritional status. Results The mean follow-up time of the whole study group was 38.08 ± 13.4 months. The follow-up time was 39 ± 13 months in patients with mortality, while it was 20 ± 15 months in those without mortality. The PNI and GNRI values were lower in patients with major adverse cardiac and cerebrovascular events (MACCE) compared to patients without MACCE. The median CONUT score was higher in patients with MACCE. Conclusion Our study showed that nutritional indices including PNI, CONUT, and GNRI were associated with long-term MACCE and mortality in patients who underwent isolated CABG. The use of these scores in order to predict prognosis in patients treated with CABG seems to be an applicable method in clinical practice.

摘要

背景 众所周知,约20%接受心脏手术的患者在术后会出现体重减轻。然而,关于营养不良的术后后果的数据却很缺乏。本研究旨在调查接受单纯冠状动脉旁路移植术(CABG)患者的营养状况与长期预后之间的关系。材料与方法 本研究纳入了2015年1月至2016年3月在我院中心接受单纯CABG的586例患者。主要结局是主要不良心脑血管事件(MACCE),定义为全因死亡、非致死性心肌梗死(MI)和中风的综合。根据MACCE结局将患者分为两组。采用预后营养指数(PNI)、老年营养风险指数(GNRI)和控制营养状况(CONUT)评分来显示营养状况。结果 整个研究组的平均随访时间为38.08±13.4个月。死亡患者的随访时间为39±13个月,未死亡患者的随访时间为20±15个月。与无MACCE的患者相比,发生主要不良心脑血管事件(MACCE)的患者PNI和GNRI值较低。MACCE患者的CONUT评分中位数较高。结论 我们的研究表明,包括PNI、CONUT和GNRI在内的营养指标与接受单纯CABG患者的长期MACCE和死亡率相关。在接受CABG治疗的患者中使用这些评分来预测预后似乎是临床实践中的一种适用方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac01/8378304/8ed8dd958622/cureus-0013-00000016567-i01.jpg

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