Malnutrition provides important long-term prognostic information in patients undergoing endovascular abdominal aortic aneurysm repair

Abstract

Objectives Malnutrition has been shown to be associated with survival in a variety of diseases. Our aim is to evaluate the prognostic value of objective nutritional indexes indicating malnutrition, in patients underwent endovascular aortic replacement. Methods We retrospectively evaluated 149 consecutive patients who underwent technically successful endovascular aortic replacement operation between October 2010 and August 2019. Objective nutritional indexes, prognostic nutritional index, geriatric nutritional risk index and controlling nutritional status, scores were calculated using the preoperative data. Optimal cut-off values were obtained by receiver operating characteristic analysis. According to the cut-off values, we investigated the relationship between indexes and the long-term all-cause mortality. Results During mean 48.0 ± 30.3 months follow-up duration, in 47 of patients (31.5%), all-cause mortality were documented. In mortality group, prognostic nutritional index (42.8 ± 7.1 vs 51.3 ± 5.2, p < 0.001) and geriatric nutritional risk index (100.7 ± 10.1 vs 107.6 ± 9.2, p < 0.001) were significantly lower, controlling nutritional status score (2.0 (1.0–4.0) vs 1.0 (0.0–2.0), p < 0.001) was higher when compared to survivor group. Kaplan–Meier curves presented higher mortality incidence in malnutrition patients evaluated with objective nutritional indexes (Log-rang test, for all three indexes p < 0.001). Besides Cox-proportional hazard analysis showed all three nutritional indexes may be a predictive marker for all-cause mortality, prognostic nutritional index introduced more valuable data than other two indexes. Conclusions Malnutrition is associated with significant increase in postoperative long-term mortality in endovascular aortic replacement patients. Preoperatively calculated objective nutritional indexes especially prognostic nutritional index can be used as an important prognostic tool.

C-reactive protein to albumin ratio provides important long-term prognostic information in patients undergoing endovascular abdominal aortic repair

“…31 Demir et al found that malnutrition had a significant effect on postoperative longterm mortality in EVAR patients. 32 Acute-phase reactants are not responsive to each inflammatory condition to a similar degree. Therefore, different prognostic scores were determined to provide more stable regulation.…”

“…31 Demir et al found that malnutrition had a significant effect on postoperative long-term mortality in EVAR patients. 32…”

El nutricionista-dietista ante el aneurisma de aorta abdominal

“…Por otro lado, se ha descrito que el estado de nutrición es un factor que influye de forma importante en la recuperación posterior a la cirugía de reparación del AAA, ya que se observa que tanto después de la cirugía abierta como la EVAR, la malnutrición y sarcopenia incrementan el riesgo de mortalidad posquirúrgica (20)(21)(22) . Además, se ha observado que el soporte nutricional posquirúrgico es una herramienta adecuada para mejorar la recuperación.…”