Incidence and impact of cardiac cachexia in valvular surgery.
Cardiac cachexia is a wasting feature of advanced heart failure, which is due to several etiologies and associated with a poor prognosis. This study assessed the incidence and impact of cardiac cachexia retrospectively in 353 patients who underwent valve surgery from June 2005 to June 2006. Using 80% of ideal body weight as a cut-off point, 46 (13%) of these patients were considered to have cardiac cachexia. Patients with cachexia were predominantly male with more underlying diseases and a lower body mass index than those without cachexia. The New York Heart Association functional class was significantly worse in patients with cachexia (class III/IV: 54.4% vs. 21.2%) and they had greater incidences of active infective endocarditis (21.7% vs. 5.2%) and tricuspid regurgitation (41.3% vs. 21.8%) compared to those with normal body weight. The cachexia group had significantly longer postoperative hospitalization and more complications (37% vs. 21.5%); perioperative mortality tended to be higher (6.5% vs. 2.3%) although not statistically significant. Cardiac cachexia remains an important problem in patients undergoing valve surgery, which indicates end-staged disease, and contributes to poor perioperative outcomes. Special care and attention are needed in this particular group of patients.
Tepsuwan
Thitipong
T
Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. Thitipong_tepsuwan@yahoo.com
Schuarattanapong
Suphachai
S
Woragidpoonpol
Surin
S
Kulthawong
Supap
S
Chaiyasri
Anong
A
Nawarawong
Weerachai
W
D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D002100:Cachexia / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D018450:Disease Progression; D004696:Endocarditis / Q000150:complications / Q000601:surgery; D005260:Female; D006333:Heart Failure / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D006349:Heart Valve Diseases / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000150:complications / Q000601:surgery