Preoperative unintended weight loss and low body mass index in relation to complications and length of stay after cardiac surgery
Preoperative unintended weight loss and low body mass index in relation to complications and length of stay after cardiac surgery
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DOI：
10.1093/ajcn/87.6.1656
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发表时间：
2008-06-01
影响因子：
7.1
通讯作者：
de Mol, Bas A. J. M.
中科院分区：
文献类型：
--
作者：
van Venrooij, Lenny M. W.;de Vos, Rien;de Mol, Bas A. J. M.
背景：一些研究报道了低体重指数（BMI;单位：kg/m2）患者心脏手术后不良结局增加。然而，鲜为人知的是，术前意外体重减轻（UWL）在心脏手术patient.Objective的影响：我们探讨了UWL的患病率和影响，鉴于低BMI，反之亦然调整一组有效的术前风险，炎症活动，体外循环的持续时间对术后不良outcome.Design：一个前瞻性队列研究进行。在入院后24小时内收集心脏手术患者的营养数据，并与标准术后并发症登记数据库相关联。多因素Logistic回归分析显示，术前6个月内UWL ≥ 10%（UWL 6 m ≥ 10%）与住院时间延长相关，与低BMI无关[比值比（OR）：7.06; 95%CI：1.78，28.04]。术前BMI = 10%UWLin6m（OR：4.62; 95%CI：1.20，17.82; OR：5.27; 95%CI：1.28，21.76）。研究人群中9.1%的心脏手术患者存在术前营养不良（UWL>= 10%6 m或BMI：5 - 21.0或两者兼有）（分别为4.3%和4.8%）。结论：从本研究中，我们建议对术前UWL>= 10%6 m或BMI：5 - 21.0的心脏手术患者给予特别关注
Background: Several studies reported increased adverse outcomes after cardiac surgery in patients with low body mass index (BMI; in kg/m(2)). Little is known yet, however, about the effect of preoperative unintended weight loss (UWL) in cardiac surgery patients.Objective: We explored the prevalence and effect of UWL in view of low BMI and vice versa adjusted for a validated set of preoperative risks, inflammatory activity, and duration of extracorporeal circulation on postoperative adverse outcome.Design: A prospective cohort study was performed. Nutritional data of cardiac surgery patients were collected within 24 h of admission and linked to the standard postoperative complication registration database.Results: The cohort consisted of 331 cases. Multivariate logistic regression analyses showed that preoperative UWL of >= 10% in the past 6 mo (>= 10%UWLin6m) was associated with a prolonged length of stay in the hospital independent from low BMI [odds ratio (OR): 7.06; 95% CI: 1.78, 28.04]. Preoperative BMI = 10%UWLin6m (OR: 4.62; 95% CI: 1.20, 17.82; and OR: 5.27; 95% CI: 1.28, 21.76, respectively). Preoperative undernutrition in cardiac surgery patients (>= 10% UWL in6m or BMI :5 21.0 or both) was present in 9.1 % of the study population (4.3% and 4.8%, respectively).Conclusions: From this study, we recommend special attention for cardiac surgery patients with preoperative >= 10%UWLin6m or BMI