title: The impact of nutritional status and appetite on the hospital length of stay and postoperative complications in elderly patients with severe aortic stenosis before aortic valve replacement.
abstract: BACKGROUND
  Severe aortic stenosis (AS) is associated with the reduction of physical activity and muscle mass and may be associated with decreased appetite.
  
  
  OBJECTIVE
  To assess the nutritional status and the impact of nutritional status and appetite on the hospital length of stay and postoperative complications in elderly patients with severe AS before aortic valve replacement.
  
  
  METHODS
  Ninety-nine patients (55 male, 44 female; 74.3 ±5.2 years old) with severe AS and an indication for aortic valve replacement (AVR) were included. The nutritional status was assessed by different questionnaires (7-point Subjective Global Assessment Score - 7-SGA, full-Mini Nutritional Assessment - full-MNA) and anthropometric measurements (body mass index (BMI) kg/m(2)). Body composition was estimated using multi-frequency bioelectrical impedance analysis. Appetite was assessed by the Simplified Nutrition Assessment Questionnaire (SNAQ).
  
  
  RESULTS
  The average BMI of patients was 28.8 ±5.8 kg/m(2). Results of the 7-SGA and f-MNA questionnaires revealed that 39 patients (39.4%) were at risk of malnutrition. The mean SNAQ score was 15.8 ±1.8. The average length of hospital stay was 10 ±5.8 days. There was a positive correlation of LOS with age (r = 0.26, p = 0.03) and a negative correlation with fat mass (kg) (r = -0.28, p = 0.04) and BMI (r = -0.22, p = 0.03). Postoperative complications were observed in 37 patients (37.4%). Patients who developed complications were older and had poorer nutritional status according to the results of the 7-SGA.
  
  
  CONCLUSIONS
  Despite many patients undergoing AVR being overweight and obese, a considerable proportion displayed clinical signs of malnutrition. The results suggest that an assessment of nutritional status and appetite in this group of patients should be conducted regularly and that the 7-SGA scale could represent a reliable tool to assess malnutrition.
authors: Department of Cardiac Surgery, Medical University of Gdansk, Poland.
authors: Dariusz
authors: D
authors: Jagielak
authors: Department of Clinical Nutrition, Medical University of Gdansk, Poland.
authors: Edyta
authors: E
authors: Wernio
authors: Department of Cardiac Surgery, Medical University of Gdansk, Poland.
authors: Radosław
authors: R
authors: Kozaryn
authors: Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany.
authors: Peter
authors: P
authors: Bramlage
authors: Department of Clinical Nutrition, Medical University of Gdansk, Poland.
authors: Marta
authors: M
authors: Gruchała-Niedoszytko
authors: Department of Cardiac Surgery, Medical University of Gdansk, Poland.
authors: Jan
authors: J
authors: Rogowski
authors: Department of Clinical Nutrition, Medical University of Gdansk, Poland.
authors: Sylwia
authors: S
authors: Małgorzewicz
keywords: aortic stenosis; appetite; body composition; elderly; nutritional status