Nutritional Screening in Cardiac Surgery

Objective: to compare the informative value of four nutritional screening scales in patients operated on the heart under extracorporeal circulation (EC). Subjects and methods. A prospective cohort study was conducted to examine the results of treatment in 894 adult patients operated on under EC. Nut...

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Main Authors: V. V. Lomivorotov, S. M. Efremov, V. A. Boboshko, P. E. Vedernikov, D. A. Nikolayev
Format: Article
Language:English
Published: Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia 2013-02-01
Series:Общая реаниматология
Online Access:https://www.reanimatology.com/rmt/article/view/166
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author V. V. Lomivorotov
S. M. Efremov
V. A. Boboshko
P. E. Vedernikov
D. A. Nikolayev
author_facet V. V. Lomivorotov
S. M. Efremov
V. A. Boboshko
P. E. Vedernikov
D. A. Nikolayev
author_sort V. V. Lomivorotov
collection DOAJ
description Objective: to compare the informative value of four nutritional screening scales in patients operated on the heart under extracorporeal circulation (EC). Subjects and methods. A prospective cohort study was conducted to examine the results of treatment in 894 adult patients operated on under EC. Nutritional screening was carried out using four scales: Nutritional Risk Screening 2002 (NRS-2002), Malnutrition Universal Screening Tool (MUST), Mini Nutritional Assessment (MNA), and Short Nutritional Assessment Questionnaire (SNAQ). Their nutritional status was assessed by the Subjective Global Assessment (SGA) scale. Mortality and postoperative complications were analyzed. Results. The MUST scale had the highest sensitivity (97.9%) in identifying malnutrition (MN). Univariate analysis of postoperative complications indicated that all the scales had a similar prognostic value: MUST [OR 2 (95% CI, 1.4—2.8); р = 0.0001], SNAQ [OR 1.8 (1.2—2.5); р=0.002], NRS-2002 [OR 1.8 (1.1—3.1); р=0.03], MNA [OR 1.8 (1.3—2.4); р=0.0007] and lower sensitivity (21.2, 23.3, 8.5, and 25.7% for SNAQ, MUST, NRS-2002, and MNA, respectively). However, multivariate analysis along with the commonly known risk factors (age, gender, EC duration) confirmed the prognostic value of the MUST [OR 1.6 (1.1—2.4); р=0.01] and MNA [OR 1.5 (1.1—2.1); р=0.02] scales. Conclusion. The MUST scale is of the most informative value in terms of its sensitivity in detecting MN and of independent prognostic value as to postoperative complications. All the scales have a poor prognostic value regarding the postoperative complications, which determines the urgency of developing a special cardiac screening scale for the nutritional status. Key words: cardiac surgery, nutritional screening, nutritional assessment, malnutrition.
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spelling doaj-art-fee6ed23773d4c039597d2102e2c8b5e2025-08-20T03:35:08ZengFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, RussiaОбщая реаниматология1813-97792411-71102013-02-019110.15360/1813-9779-2013-1-43166Nutritional Screening in Cardiac SurgeryV. V. LomivorotovS. M. EfremovV. A. BoboshkoP. E. VedernikovD. A. NikolayevObjective: to compare the informative value of four nutritional screening scales in patients operated on the heart under extracorporeal circulation (EC). Subjects and methods. A prospective cohort study was conducted to examine the results of treatment in 894 adult patients operated on under EC. Nutritional screening was carried out using four scales: Nutritional Risk Screening 2002 (NRS-2002), Malnutrition Universal Screening Tool (MUST), Mini Nutritional Assessment (MNA), and Short Nutritional Assessment Questionnaire (SNAQ). Their nutritional status was assessed by the Subjective Global Assessment (SGA) scale. Mortality and postoperative complications were analyzed. Results. The MUST scale had the highest sensitivity (97.9%) in identifying malnutrition (MN). Univariate analysis of postoperative complications indicated that all the scales had a similar prognostic value: MUST [OR 2 (95% CI, 1.4—2.8); р = 0.0001], SNAQ [OR 1.8 (1.2—2.5); р=0.002], NRS-2002 [OR 1.8 (1.1—3.1); р=0.03], MNA [OR 1.8 (1.3—2.4); р=0.0007] and lower sensitivity (21.2, 23.3, 8.5, and 25.7% for SNAQ, MUST, NRS-2002, and MNA, respectively). However, multivariate analysis along with the commonly known risk factors (age, gender, EC duration) confirmed the prognostic value of the MUST [OR 1.6 (1.1—2.4); р=0.01] and MNA [OR 1.5 (1.1—2.1); р=0.02] scales. Conclusion. The MUST scale is of the most informative value in terms of its sensitivity in detecting MN and of independent prognostic value as to postoperative complications. All the scales have a poor prognostic value regarding the postoperative complications, which determines the urgency of developing a special cardiac screening scale for the nutritional status. Key words: cardiac surgery, nutritional screening, nutritional assessment, malnutrition.https://www.reanimatology.com/rmt/article/view/166
spellingShingle V. V. Lomivorotov
S. M. Efremov
V. A. Boboshko
P. E. Vedernikov
D. A. Nikolayev
Nutritional Screening in Cardiac Surgery
Общая реаниматология
title Nutritional Screening in Cardiac Surgery
title_full Nutritional Screening in Cardiac Surgery
title_fullStr Nutritional Screening in Cardiac Surgery
title_full_unstemmed Nutritional Screening in Cardiac Surgery
title_short Nutritional Screening in Cardiac Surgery
title_sort nutritional screening in cardiac surgery
url https://www.reanimatology.com/rmt/article/view/166
work_keys_str_mv AT vvlomivorotov nutritionalscreeningincardiacsurgery
AT smefremov nutritionalscreeningincardiacsurgery
AT vaboboshko nutritionalscreeningincardiacsurgery
AT pevedernikov nutritionalscreeningincardiacsurgery
AT danikolayev nutritionalscreeningincardiacsurgery