| Abstract [eng] |
Malnutrition (MN) and its assessment is still a major clinical and scientific problem. The purpose of the research is to identify the impact of preoperative MN on early postoperative complications in cardiac surgery. After analysing the data of 712 patients gathered during the study, the following conclusions were made: a phase angle (PA) determined by bioelectrical impedance analysis (BIA) is an indicator of nutritional status with the cut-off value of <15 percentile being a marker of MN; the most accurate screening tool to detect MN risks in cardiac surgery patients is Nutritional Risk Screening 2002 (NRS-2002); MN detected by BIA-derived PA was diagnosed for 17,8 % of low-risk cardiac surgery patients and 22,9 % overall and is more frequently diagnosed than low fat-free mass index (FFMI) and body mass index (BMI); preoperative malnutrition is associated with structural and functional affection of the heart, co-morbidities, appetite, mobility and immune system’s condition and the development of early postoperative complications increasing the odds of postoperative morbidity by 2.5 times and length of hospital stay, but it has no effects on postoperative mortality.Practical recommendations: preoperative assessment of nutritional status for cardiac surgery patients is recommended using the PA or Nutritional Risk Screening 2002 (NRS-2002) with special attention payed to patients with the following risk factors for malnutrition: heart failure in functional NYHA class IV, faulty heart valves (particularly, mitral valve insufficiency ≥II°), preoperative renal failure, low BMI or loss of weight, lack of appetite, impaired mobility, anaemia and the elevated C-reactive protein level; after diagnosing malnutrition or nutritional risk to inform a clinical nutrition team and/or establish protocols for nutritional monitoring and dietary adjustments. |
