4.6 Article

Prognostic implications of Global Leadership Initiative on Malnutrition-defined malnutrition in older patients who underwent cardiac surgery in China

Journal

SURGERY
Volume 173, Issue 2, Pages 472-478

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.surg.2022.11.008

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This study aimed to investigate the prognostic implications of malnutrition defined by the Global Leadership Initiative on Malnutrition in older patients who underwent cardiac surgery. The results showed that patients with Global Leadership Initiative on Malnutrition-defined malnutrition had higher risks of postoperative complications and poor overall survival. Therefore, the comprehensive preoperative risk assessment of cardiac surgery using the Global Leadership Initiative on Malnutrition assessment is necessary.
Background: The proportion of older patients who are candidates for cardiac surgery is increasing. Growing evidence has shown that malnutrition is associated with a poor prognosis after cardiac surgery. The present study aimed to investigate the prognostic implications of malnutrition defined by the Global Leadership Initiative on Malnutrition in older patients who underwent cardiac surgery.Methods: From November 2015 to January 2021, 401 older patients who underwent cardiac surgery were retrospectively enrolled and evaluated using the Global Leadership Initiative on Malnutrition criteria. The perioperative characteristics and clinical outcomes were collected. The independent risk factors for postoperative complications and overall survival were analyzed.Results: The prevalence of Global Leadership Initiative on Malnutrition-defined malnutrition was 22.7% in this study. Patients with Global Leadership Initiative on Malnutrition-defined malnutrition had higher risks of postoperative complications (65.9% vs 49.7%, P = .006) and poor overall survival (68.1% vs 83.9%, P = .0019). Global Leadership Initiative on Malnutrition-defined malnutrition was also related to a longer postoperative hospital stay and prolonged intensive care stay. Five factors were identified as in-dependent risk factors for overall survival: Global Leadership Initiative on Malnutrition-defined malnutrition (P = .009), chronic heart failure (P = .007), atrial fibrillation (P = .029), operative time (P < .001) and hemoglobin (P = .044).Conclusion: We demonstrated the prognostic implications of Global Leadership Initiative on Malnutrition-defined malnutrition in older patients who underwent cardiac surgery for the first time. This study highlights the necessity of using the Global Leadership Initiative on Malnutrition assessment in the comprehensive preoperative risk assessment of cardiac surgery.(c) 2022 Elsevier Inc. All rights reserved.

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