Cardiology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Cardiothoracic Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Nutrients. 2022 Dec 2;14(23):5137. doi: 10.3390/nu14235137.
It is suggested that older patients waiting for an elective surgical procedure have a poor nutritional status and low physical activity level. It is unknown if this hypothesis is true and if these conditions improve after a medical procedure. We aimed to determine the trajectory of both conditions before and after transcatheter aortic valve implantation (TAVI). Included patients (n = 112, age 81 ± 5 years, 58% male) received three home visits (preprocedural, one and six months postprocedural). Nutritional status was determined with the mini nutritional assessment—short form (MNA-SF) and physical activity using an ankle-worn monitor (Stepwatch). The median MNA-SF score was 13 (11−14), and 27% of the patients were at risk of malnutrition before the procedure. Physical activity was 6273 ± 3007 steps/day, and 69% of the patients did not meet the physical activity guidelines (>7100 steps/day). We observed that nutritional status and physical activity did not significantly change after the procedure (β 0.02 [95% CI −0.03, 0.07] points/months on the MNA-SF and β 16 [95% CI −47, 79] steps/month, respectively). To conclude, many preprocedural TAVI patients should improve their nutritional status or activity level. Both conditions do not improve naturally after a cardiac procedure.
建议等待择期手术的老年患者存在营养状况差和低身体活动水平的情况。目前尚不清楚这一假设是否正确,以及这些情况在医疗程序后是否会得到改善。我们旨在确定经导管主动脉瓣植入术(TAVI)前后这两种情况的轨迹。纳入的患者(n=112,年龄 81±5 岁,58%为男性)接受了三次家庭访视(术前、术后 1 个月和 6 个月)。使用微型营养评估-短表(MNA-SF)确定营养状况,使用踝部佩戴式监测器(Stepwatch)测量身体活动。MNA-SF 评分中位数为 13(11-14),术前有 27%的患者存在营养不良风险。身体活动量为 6273±3007 步/天,69%的患者未达到身体活动指南(>7100 步/天)。我们观察到术后营养状况和身体活动没有显著变化(MNA-SF 评分每月增加 0.02[95%CI-0.03,0.07]分,每月增加 16 步[95%CI-47,79])。总之,许多术前 TAVI 患者应改善其营养状况或活动水平。心脏手术后,这两种情况不会自然改善。