title: Heart surgery stems increased nutritional risk, expressed during the course of stationary rehabilitation.
abstract: BACKGROUND
  Cardiovascular diseases are a vast global health burden. Despite common prevalence, current knowledge and investigations concerning nutritional aspects are limited. Characteristics and dynamics of nutritional risk are not entirely known for most of the entities, disease stages or treatment-induced fluctuations. This study assessed the effects of heart surgery on unintentional weight loss and nutritional risk using the NRS-2002.
  
  
  METHODS
  A noninterventional study that included patients scheduled for rehabilitation 1-6 months after heart surgery was performed. Evaluation included routine cardiovascular diagnostics and review of medical histories. Documented baseline weight was available for >85% of the patients. Nutritional risk screening was performed with the standardized NRS-2002 questionnaire.
  
  
  RESULTS
  A total of 145 patients were involved, with a mean age of 65.3 ± 11.5 years in a range of 23-84 years. The male to female ratio was 121:24 (83.4%:16.6%), respectively. Coronary artery bypass graft surgery (CABG) was performed in 89 patients (61.4%), valvular surgery (VS) in 34 (23.4%) and combined operations (CABG + VS) in 22 (15.2%). Percentage weight loss history was 11.1 ± 3.4% in a range of 0-20.1%, while NRS-2002 was 4.77 ± 1.05 in a range of 1-6. Increased nutritional risk (NRS-2002 ≥3) was found in nearly all patients. Combined ischemic and valvular etiology displayed the highest values of NRS-2002 (5.0 ± 1.2). Patient age and creatinine showed significant correlations with NRS-2002 (Rho = 0.521, p < 0.001 and Rho = 0.335, p < 0.001, respectively).
  
  
  CONCLUSIONS
  Increased nutritional risk was found to be frequently prevalent in patients scheduled for rehabilitation after heart surgery. Risk was found to be in relation with underlying coronary artery disease as well as with the age of patients and parameters of renal function. Routine application of nutritional risk screening appears to be a valuable clinical tool for detecting this relevant comorbidity, particularly since no connection was found with traditional anthropometrics.
authors.affiliation: Department of Cardiology, University Hospital 'Thalassotherapia Opatija', Opatija, Croatia.
authors.forename: M
authors.initials: M
authors.lastname: Boban
authors.forename: V
authors.initials: V
authors.lastname: Persic
authors.forename: B
authors.initials: B
authors.lastname: Miletic
authors.forename: K
authors.initials: K
authors.lastname: Kovacicek
authors.forename: Z
authors.initials: Z
authors.lastname: Madzar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000601:surgery*; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D011182:Postoperative Care; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015431:Weight Loss; D055815:Young Adult