Associations of sarcopenia and malnutrition with 30-day in-hospital morbidity and mortality after cardiac surgery

Sarcopenia and malnutrition often occur simultaneously in adults with cardiovascular diseases. Our objective was to determine the associations of preoperative sarcopenia and malnutrition with major adverse cardiac and cerebral events (MACCE) after cardiac surgery. We retrospectively analysed 154 con...

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Veröffentlicht in:European journal of cardio-thoracic surgery 2024-12, Vol.67 (1)
Hauptverfasser: Abe, Takahiro, Inao, Tasuku, Shingu, Yasushige, Yamada, Akira, Takada, Shingo, Fukushima, Arata, Oyama-Manabe, Noriko, Yokota, Isao, Wakasa, Satoru, Kinugawa, Shintaro, Yokota, Takashi
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container_title European journal of cardio-thoracic surgery
container_volume 67
creator Abe, Takahiro
Inao, Tasuku
Shingu, Yasushige
Yamada, Akira
Takada, Shingo
Fukushima, Arata
Oyama-Manabe, Noriko
Yokota, Isao
Wakasa, Satoru
Kinugawa, Shintaro
Yokota, Takashi
description Sarcopenia and malnutrition often occur simultaneously in adults with cardiovascular diseases. Our objective was to determine the associations of preoperative sarcopenia and malnutrition with major adverse cardiac and cerebral events (MACCE) after cardiac surgery. We retrospectively analysed 154 consecutive patients who underwent elective cardiac surgery between January 2015 and June 2018 at two institutions in Japan. Sarcopenia and nutritional status were preoperatively assessed by bilateral psoas muscle volume index (PMVI) using CT scans and the prognostic nutritional index (PNI), respectively. The median age in the total cohort was 69 years, and 43% were women. Within 30 days after surgery, 20 patients developed in-hospital MACCE and seven patients died of any cause. Low PMVI (
doi_str_mv 10.1093/ejcts/ezae456
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Our objective was to determine the associations of preoperative sarcopenia and malnutrition with major adverse cardiac and cerebral events (MACCE) after cardiac surgery. We retrospectively analysed 154 consecutive patients who underwent elective cardiac surgery between January 2015 and June 2018 at two institutions in Japan. Sarcopenia and nutritional status were preoperatively assessed by bilateral psoas muscle volume index (PMVI) using CT scans and the prognostic nutritional index (PNI), respectively. The median age in the total cohort was 69 years, and 43% were women. Within 30 days after surgery, 20 patients developed in-hospital MACCE and seven patients died of any cause. Low PMVI (&lt;72.25 cm3/m2) and low PNI (&lt;48.15) were each independent predictors of postoperative MACCE occurrence with odds ratios (95% confidence interval) of 3.58 (1.22-10.53) and 3.73 (1.25-11.09) when adjusted for age and sex, and 3.25 (1.07-9.87) and 3.27 (1.08-9.89) when adjusted for preoperative left ventricular ejection fraction, angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker, and anticoagulant. In addition, the combination of low PMVI and low PNI conferred the highest risk of in-hospital MACCE among the four groups (i.e. the low PMVI, low PNI, low PMVI + low PNI and neither low PMVI nor low PNI groups). Preoperative low PMVI and low PNI were respectively associated with 30-day in-hospital MACCE occurrence after cardiac surgery. 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Low PMVI (&lt;72.25 cm3/m2) and low PNI (&lt;48.15) were each independent predictors of postoperative MACCE occurrence with odds ratios (95% confidence interval) of 3.58 (1.22-10.53) and 3.73 (1.25-11.09) when adjusted for age and sex, and 3.25 (1.07-9.87) and 3.27 (1.08-9.89) when adjusted for preoperative left ventricular ejection fraction, angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker, and anticoagulant. In addition, the combination of low PMVI and low PNI conferred the highest risk of in-hospital MACCE among the four groups (i.e. the low PMVI, low PNI, low PMVI + low PNI and neither low PMVI nor low PNI groups). Preoperative low PMVI and low PNI were respectively associated with 30-day in-hospital MACCE occurrence after cardiac surgery. 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subjects Aged
Cardiac Surgical Procedures - adverse effects
Cardiac Surgical Procedures - mortality
Female
Hospital Mortality
Humans
Japan - epidemiology
Male
Malnutrition - complications
Malnutrition - epidemiology
Malnutrition - mortality
Middle Aged
Nutritional Status
Postoperative Complications - epidemiology
Postoperative Complications - mortality
Retrospective Studies
Risk Factors
Sarcopenia - complications
Sarcopenia - epidemiology
Sarcopenia - mortality
title Associations of sarcopenia and malnutrition with 30-day in-hospital morbidity and mortality after cardiac surgery
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