Preoperative Nutritional Status and Clinical Complications in the Postoperative Period of Cardiac Surgeries

Abstract

ObjectiveThis study aims to assess the preoperative nutritional status of patients and the role it plays in the occurrence of clinical complications in the postoperative period of major elective cardiac surgeries.MethodsCross-sectional study comprising 72 patients aged 20 years or older, who underwent elective cardiac surgery. The preoperative nutritional assessment consisted of nutritional screening, anthropometry (including the measurement of the adductor pollicis muscle thickness) and biochemical tests. The patients were monitored for up to 10 days after the surgery in order to control the occurrence of postoperative complications. The R software, version 3.0.2, was used to statistically analyze the data.ResultsClinical complications were found in 62.5% (n=42) of the studied samples and complications of non-infectious nature were most often found. Serum albumin appeared to be associated with renal complications (P=0.026) in the nutritional status indicators analyzed herein. The adductor pollicis muscle thickness was associated with infectious complications and presented mean of 9.39±2.32 mm in the non-dominant hand (P=0.030). No significant correlation was found between the other indicators and the clinical complications.ConclusionThe adductor pollicis muscle thickness and the serum albumin seemed be associated with clinical complications in the postoperative period of cardiac surgeries.

Use of adductor pollicis muscle thickness in hospitalized or ambulatory patients: a systematic review

“…In a study carried out in the city of Salvador (BA) in the year of 2016, APMT did not present a significant association with the presence of complications in the PP in either hand (DH p = 0.217 and NDH p = 0.148). However, the APMT of the NDH was significantly associated with specific infectious complications (p = 0.030) 12 . In another study conducted in the same year in Recife (PE), APMT was compared to the gold-standard GSA method, but did not present a significant association (DH p = 0.513 and NDH p = 0.842) 13 ).…”

“…Minimum and maximum mean APMT values (mm) were, respectively, 7.03 ± 2.71 (LH) and 20.4 ± 6 (RH) in critically ill patients 2 - 5 ; 12.0 ± 3.6 (NDH) and 12.9 ± 3.5 (DH) in cancer patients 14 ; 10 ± 4.5 (BH) and 11.9 ± 3.07 (BH) in nephropathic patients 17 - 19 ; 9.54 ± 2.5 (BH) and 16.98 ± 2.80 (RH) in surgical patients 6 , 7 , 12 , 13 ); and 16.6±3.5 and a median of 7.1 in hepatopathic patients 22 , 24 . However, these data refer to only 14 studies that provided such values.…”

Risk Factors and Outcomes Associated With Sepsis After Coronary Artery Bypass and Open Heart Valve Surgeries

“…Low serum albumin concentration and poor nutrition have been linked to various complications after cardiac surgery. 39,40 It is important to note, however, that the most recent consensus statement from the Academy of Nutrition and Dietetics/the American Society for Parenteral and Enteral Nutrition does not include serum albumin as a defining characteristic of malnutrition, because recent evidence shows that serum albumin concentration is not altered by changes in nutrition. 41 We hypothesize that hypoalbuminemia in post–cardiac surgery sepsis may be explained by albumin’s role as a negative acute-phase reactant rather than as a surrogate for nutritional status.…”

Successful Triple Valve Surgery in an Undernourished Patient: What to Prepare?

“…Subjective global assessment (SGA) combines elements of history and physical examination and has been validated as a tool for assessing malnutrition in a variety of conditions. When SGA is applied to cardiac patients, most of them will be assessed for malnutrition than the standard anthropometric measurement combined with albumin and leukocyte values (Gonçalves, Jesus, Gonçalves, Deiró, & Dias, 2016;Rahman et al, 2014;Stoppe et al, 2017).…”