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Effects of preoperative nutritional status on disability-free survival after cardiac and thoracic aortic surgery: a prospective observational study

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Abstract

Purpose

Preoperative malnutrition is associated with postoperative complications, prolonged intensive care unit stay, and mortality, leading to functional disability after non-cardiac surgery. However, its effects on cardiac and thoracic aortic surgery outcomes remain unknown. We examined the effects of preoperative malnutrition on disability-free survival after surgery and assessed the perioperative 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS2.0) score based on the preoperative nutritional status.

Methods

We included individuals aged ≥ 55 years who underwent elective cardiac and/or thoracic aortic surgery between April 1, 2016 and December 28, 2018 in a tertiary center. The nutritional status was assessed preoperatively using the Mini Nutritional Assessment Short Form, with scores < 12 points indicating a poor nutritional status. The JapanSCORE2 was calculated for surgical risk prediction. Our primary outcome was disability-free survival 1 year after surgery (WHODAS2.0 score: < 16%). The odds ratio of poor nutritional status for disability-free survival was calculated using multiple logistic regression analysis after adjusting for age, JapanSCORE2, and duration of surgery.

Results

One hundred patients were followed up for 1 year. Preoperatively, 41 of them had a poor nutritional status. The disability-free survival rates 1 year postoperatively were 46.3% (19/41) and 64.4% (38/59) in patients with and without poor preoperative nutritional status, respectively. The adjusted odds ratio of poor nutritional status for disability-free survival at 1 year after surgery was 0.42 (95% confidence interval, 0.17–0.99).

Conclusion

Patients with a poor preoperative nutritional status had less likely to show disability-free survival 1 year after cardiac and thoracic aortic surgery.

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Data availability

Data pertaining to this study are available as a spreadsheet file upon reasonable request.

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Acknowledgements

Ozu Naoki (Department of Medical Statistics, Nara Medical University, Nara, Japan) advised and assisted with the statistical planning and analysis. We would like to thank Editage (www.editage.com) for English language editing.

Funding

This study was funded by the Nara Medical University Grant-in-Aid for a large-scale prospective cohort study on healthy life expectancies. The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Department of Anesthesiology, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan

    Hideaki Kawanishi, Mitsuru Ida, Yusuke Naito & Masahiko Kawaguchi

Authors
  1. Hideaki Kawanishi
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  2. Mitsuru Ida
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  3. Yusuke Naito
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  4. Masahiko Kawaguchi
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Contributions

HK: data collection and draft writing. MI: Study coordinator, study conception and design, interpretation of data, and revision of the draft. YN: Study conception and design, interpretation of data, and manuscript revision. MK: Study conception and design, interpretation of data, and manuscript revision. All authors critically reviewed the manuscript and approved the final version.

Corresponding author

Correspondence to Mitsuru Ida.

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The authors declare that they have no conflicts of interest.

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Kawanishi, H., Ida, M., Naito, Y. et al. Effects of preoperative nutritional status on disability-free survival after cardiac and thoracic aortic surgery: a prospective observational study. J Anesth 37, 401–407 (2023). https://doi.org/10.1007/s00540-023-03178-4

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  • DOI: https://doi.org/10.1007/s00540-023-03178-4

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