Wilimski Radosław, Marszałek Mikołaj, Walkowski Bartosz, Michalski Wojciech, Eyileten Ceren, Przekop Zuzanna, Małachowska Aleksandra, Grochowska Anita, Sosnowska Maja, Kuśmierczyk Mariusz
Department of Cardio-Thoracic Surgery and Transplantology, Medical University of Warsaw, Warsaw, Poland.
Department of Clinical and Experimental Pharmacology, Medical University of Warsaw, Warsaw, Poland.
Postepy Kardiol Interwencyjnej. 2023 Sep;19(3):233-242. doi: 10.5114/aic.2023.131476. Epub 2023 Sep 27.
Bioelectrical impedance analysis is a widely available, non-invasive method for body composition assessment.
To elucidate the perioperative body composition alterations and their prognostic utility for hospital length of stay (LOS) in low risk, off-pump coronary artery bypass (OPCAB) patients.
Fifty patients undergoing elective OPCAB were included in the study. Body composition assessments were performed 1 day before the scheduled surgery and on the 6th postoperative day. Patients were grouped into < 9 days ( = 29, 58%) and ≥ 9 days ( = 21, 42%). Multivariate logistic regression analysis was performed to create a body composition-based screening panel for prolonged hospital stay.
No significant differences in anthropometric measurements, clinical characteristics or occurrence of postoperative complications were detected between the study groups. Patients with longer hospitalization had significantly higher content of fat mass (FM%) and fat mass index (FMI), and significantly lower content of fat free mass (FFM%) baseline parameters ( = 0.011, = 0.04 and = 0.012, respectively). High FM% values had 15-fold, low FFM% values had 13-fold and high FMI values had 7-fold higher risk of experiencing longer stay in the hospital ( = 0.001, = 0.001 and = 0.005, respectively). The combined panel of three variables (higher FM%, lower FFM% and higher FMI) had 16-fold higher risk of longer hospitalization (adjusted OR = 16.40; 95% CI: 3.52-76.34; = 0.0004).
Preoperative high FM and low FFM content are independent predictors of prolonged hospital length of stay in normal- and increased-BMI patients after OPCAB.
生物电阻抗分析是一种广泛应用的、用于身体成分评估的非侵入性方法。
阐明低风险非体外循环冠状动脉搭桥术（OPCAB）患者围手术期身体成分的变化及其对住院时间（LOS）的预后价值。
本研究纳入了50例行择期OPCAB的患者。在预定手术前1天和术后第6天进行身体成分评估。患者被分为住院时间<9天（n = 29，58%）和≥9天（n = 21，42%）两组。进行多因素逻辑回归分析，以建立基于身体成分的延长住院时间筛查指标。
研究组之间在人体测量学指标、临床特征或术后并发症发生率方面未检测到显著差异。住院时间较长的患者脂肪量（FM%）和脂肪量指数（FMI）含量显著更高，而无脂肪量（FFM%）基线参数显著更低（分别为P = 0.011、P = 0.04和P = 0.012）。FM%值高的患者住院时间延长的风险高15倍，FFM%值低的患者高13倍，FMI值高的患者高7倍（分别为P = 0.001、P = 0.001和P = 0.005）。三个变量（较高的FM%、较低的FFM%和较高的FMI）的联合指标使住院时间延长的风险高16倍（调整后的OR = 16.40；95%CI：3.52 - 76.34；P = 0.0004）。
术前FM含量高和FFM含量低是OPCAB术后正常和BMI增加患者住院时间延长的独立预测因素。
