Effect of nutritional status on mortality in patients undergoing coronary artery bypass grafting

Keskin, Muhammed; İpek, Göktük; Aldağ, Mustafa; Altay, Servet; Hayıroğlu, Mert İlker; Börklü, Edibe Betül; İnan, Duygu; Kozan, Ömer

doi:10.1016/j.nut.2017.10.024

Cited by 20 publications

(17 citation statements)

References 12 publications

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“…Various studies have reported that a lower PNI level was significantly associated with higher mortality in patients with cardiovascular diseases, including myocardial infarction and pulmonary embolism [38]. The PNI was first examined in terms of coronary bypass surgery by Keskin et al, [39] and they found that a low preoperative PNI level is an independent prognostic factor for mortality in these patients. However, no previous studies have investigated the association between the preoperative PNI and the development of kidney injury among patients undergoing on-pump CABG surgery.…”

Section: Discussionmentioning

confidence: 99%

The predictive value of the prognostic nutritional index for postoperative acute kidney injury in patients undergoing on-pump coronary bypass surgery

Dolapoglu

Avcı

Kırış

et al. 2019

J Cardiothorac Surg

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Background We aimed to investigate the predictive value of the prognostic nutritional index (PNI) regarding the development of acute kidney injury (AKI) after elective coronary artery bypass grafting (CABG). Methods A total of 336 consecutive patients with normal serum creatinine levels undergoing CABG were enrolled in this retrospective study. AKI was defined as meeting Acute Kidney Injury Network (AKIN) criteria based on the occurrence of creatinine changes within the first 48 h after CABG surgery. The patients were grouped according to whether they developed AKI or not into an AKI (−) and an AKI (+) group. Results AKI developed in 88 (26.2%) of all patients. The PNI was independently predictive of AKI (OR: 0.829, 95% CI: 0.783–0.877, p < 0.001). Moreover, C-reactive protein (CRP), a history of diabetes mellitus, and positive inotropric usage were independent risk factors for AKI in the multivariate logistic regression analysis. The area under the curve (AUC) of the multivariable model, including positive inotrope support, a history of diabetes mellitus, and CRP, was 0.693 (95% CI: 0.626–0.760, p < 0.001) in predicting AKIN. When the PNI was added to the multivariable model, the AUC was 0.819 (95% CI, 0.762–0.865, z = 3.777, difference p = 0.0002). Also, the addition of the PNI to the multivariable model was associated with a significant net reclassification improvement estimated at 88.2% ( p < 0.001) and an integrated discrimination improvement of 0.22 ( p < 0.001). Conclusions Our study demonstrated that decreasing the PNI could be associated with the development of AKI after coronary artery bypass surgery.

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Section: Discussionmentioning

confidence: 99%

The predictive value of the prognostic nutritional index for postoperative acute kidney injury in patients undergoing on-pump coronary bypass surgery

Dolapoglu

Avcı

Kırış

et al. 2019

J Cardiothorac Surg

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“…The significance of evaluating nutritional status has been gathering clinical attention in a wide range of diseased populations for its usefulness as a prognostic indicator. In the field of cardiovascular diseases, the association between malnutrition or poor nutritional status and adverse outcomes, in other words, an elevated risk of adverse outcomes in undernourished populations, has been reported in patients with coronary artery disease [13,19], heart failure [14,20], peripheral artery disease [21] patients who underwent coronary artery bypass graft surgery [22,23], valvular surgery [24], or trans arterial valve implantation (TAVI) [25]. In patients with critical situations, the adverse prognostic impact of the malnutrition on short-term in-hospital mortality has been evaluated in patients hospitalized in intensive care units (ICU) [1,2].…”

Section: Discussionmentioning

confidence: 99%

A Novel Nutritional Index Serves as A Useful Prognostic Indicator in Cardiac Critical Patients Requiring Mechanical Circulatory Support

et al. 2019

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Background: A poor nutritional status has been gathering intense clinical interest recently as it has been suggested to associate with adverse outcomes in patients in the intensive care unit (ICU). However, there is still no established nutritional index dominantly used in clinical practice. We have previously proposed a novel nutritional index, which can be calculated using serum levels of triglycerides, total cholesterol, and body weight (TCBI). In this study, to expand the application of TCBI for critical patients, we investigated the usefulness of TCBI to predict prognosis in hemodynamically unstable patients with percutaneously implantable mechanical circulatory support (MCS) devices in the ICU. Patients and Methods: This is a retrospective analysis of a multicenter registry consisting of three Juntendo University hospitals in Japan involving patients who received MCS devices, including intra-aortic balloon pumping (IABP) with or without veno-arterial extracorporeal membrane oxygenation (VA-ECMO), between 2012 and 2016 (n = 439). The median follow-up period was 298 days. Results: Spearman’s correlation coefficient between TCBI and the geriatric nutritional risk index (GNRI) was 0.44 (p < 0.0001), indicating a moderate positive correlation for these two variables. Unadjusted Kaplan–Meier analysis demonstrated reduced risks of all-cause and cardiovascular mortalities in patients with higher tertiles of TCBI. Furthermore, adjusted multivariate Cox proportional hazard analyses revealed that the highest tertile TCBI was an independent predictor for the reduced risk of all-cause mortality (hazard ratio (HR): 0.22, 95% confidence interval: 0.10–0.48, p < 0.0001) and cardiovascular mortality (0.20, 0.09–0.45, p < 0.0001). Conclusion: A novel and simple to calculate nutritional index, TCBI, can be applicable as a prognostic indicator in hemodynamically unstable patients requiring MCS devices.

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“…In another study of stable angina patients undergoing PCI, malnourished patients characterized by a higher CONUT score had more major adverse cardiac events (HR 1.30–2.07; p < 0.0001) [4]. Similar associations between low PNI, a marker of poor nutrition, and increased mortality have been observed in stable CAD patients following PCI or coronary artery bypass grafting [5,6]. Despite these observed associations with hard outcomes, nutritional indices have not gained traction in clinical practice in part because they employ parameters, such as serum albumin and total lymphocytes, which are not routinely collected in CAD patients.…”

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confidence: 77%

Paradoxically simple: A new nutritional index for predicting coronary risk

Yang-Giuliano

Osborn

2018

International Journal of Cardiology

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Effect of nutritional status on mortality in patients undergoing coronary artery bypass grafting

Cited by 20 publications

References 12 publications

The predictive value of the prognostic nutritional index for postoperative acute kidney injury in patients undergoing on-pump coronary bypass surgery

The predictive value of the prognostic nutritional index for postoperative acute kidney injury in patients undergoing on-pump coronary bypass surgery

A Novel Nutritional Index Serves as A Useful Prognostic Indicator in Cardiac Critical Patients Requiring Mechanical Circulatory Support

Paradoxically simple: A new nutritional index for predicting coronary risk

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