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Poor preoperative nutritional status is an important predictor of the retardation of rehabilitation after cardiac surgery in elderly cardiac patients

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Abstract

Background

Preoperative nutritional status and physical function are important predictors of mortality and morbidity after cardiac surgery. However, the influence of nutritional status before cardiac surgery on physical function and the progress of postoperative rehabilitation requires clarification.

Aims

To determine the effect of preoperative nutritional status on preoperative physical function and progress of rehabilitation after elective cardiac surgery.

Methods

We enrolled 131 elderly patients with mean age of 73.7 ± 5.8 years undergoing cardiac surgery. We divided them into two groups by nutritional status as measured by the Geriatric Nutritional Risk Index (GNRI): high GNRI group (GNRI ≥ 92, n = 106) and low GNRI group (GNRI < 92, n = 25). Physical function was estimated by handgrip strength, knee extensor muscle strength (KEMS), the Short Physical Performance Battery (SPPB), and 6-minute walk test (6MWT). Progress of postoperative rehabilitation was evaluated by the number of days to independent walking after surgery, length of stay in the ICU, and length of hospital stay.

Results

After adjusting for potential confounding factors, preoperative handgrip strength (P = 0.034), KEMS (P = 0.009), SPPB (P < 0.0001), and 6MWT (P = 0.012) were all significantly better in the high GNRI group. Multiple regression analysis revealed that a low GNRI was an independent predictor of the retardation of postoperative rehabilitation.

Conclusions

Preoperative nutritional status as assessed by the GNRI could reflect perioperative physical function. Preoperative poor nutritional status may be an independent predictor of the retardation of postoperative rehabilitation in patients undergoing elective cardiac surgery.

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Acknowledgments

We thank the staff members of Kobe University Hospital who collaborated in this study. The data of this study were previously presented at the 79th Annual Scientific Meeting of the Japanese Circulation Society.

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Authors and Affiliations

  1. Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan

    Masato Ogawa

  2. Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan

    Masato Ogawa, Kazuhiro P. Izawa & Rei Ono

  3. Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan

    Seimi Satomi-Kobayashi

  4. Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan

    Aki Kitamura & Yutaka Okita

  5. Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, Japan

    Yoshitada Sakai

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  1. Masato Ogawa
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  2. Kazuhiro P. Izawa
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  3. Seimi Satomi-Kobayashi
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  4. Aki Kitamura
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Corresponding author

Correspondence to Kazuhiro P. Izawa.

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The authors declare that there are no conflicts of interest.

Statement of human and animal rights

The participants received oral explanations of the research procedures from the researchers. This study was approved by the Kobe University Institutional Committee on Human Research.

Informed consent

Written informed consent was obtained from each patient.

Funding

This research received no grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Ogawa, M., Izawa, K.P., Satomi-Kobayashi, S. et al. Poor preoperative nutritional status is an important predictor of the retardation of rehabilitation after cardiac surgery in elderly cardiac patients. Aging Clin Exp Res 29, 283–290 (2017). https://doi.org/10.1007/s40520-016-0552-3

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  • DOI: https://doi.org/10.1007/s40520-016-0552-3

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