A recent multicenter study investigated the relationship between preoperative nutritional indices and clinical outcomes in patients undergoing coronary artery bypass grafting.
In the study, published in the Heart Journal, investigators analyzed data from over 5,000 patients across various demographics, focusing on how preoperative nutritional indices (PNI) scores could predict postoperative morbidity and mortality.
The investigators revealed that lower PNI scores were significantly associated with higher rates of postoperative complications such as infections, prolonged hospital stays, and elevated mortality. Specifically, patients with a PNI score below 45 exhibited a 30% higher risk of adverse outcomes compared with those with higher scores (P < .05). Additionally, PNI independently predicted long-term survival, with a hazard ratio of 1.45 for all-cause mortality after adjusting for age, sex, and comorbidities.
To better understand these outcomes, the investigators assessed correlations between nutritional status, immune response, inflammatory markers, and wound healing rates. Patients with lower PNI scores showed elevated levels of C-reactive protein (CRP) and interleukin (IL)-6, indicating a heightened inflammatory state potentially hindering recovery. These patients also experienced delayed wound healing and higher readmission rates, underscoring the broader impact of nutritional health on surgical outcomes.
Further, preliminary data suggested that patients receiving targeted nutritional support prior to surgery experienced improved outcomes, including shorter hospital stays and fewer complications. The results highlighted the importance of comprehensive nutritional assessments and personalized intervention strategies in preoperative care plans.
"The PNI [score] emerges as a valuable prognostic predictor for both short- and long-term outcomes among coronary artery bypass grafting (CABG)-treated patients. Notably, [the] PNI [score] assessed at various time points reveals a consistent pattern of initial decline followed by recovery and plays a significant and meaningful role in predicting the mortality of CABG-treated patients," said lead study author Lin Sun, of the Department of Cardiovascular Surgery at Shanghai Chest Hospital of the Shanghai Jiao Tong University School of Medicine in Shanghai, China, and colleagues.
The investigators emphasized the need to integrate nutritional optimization into standard preoperative care. They recommended prospective studies to validate the findings and explore the broader benefits of nutritional support programs tailored to cardiac surgical patients. Developing standardized nutritional screening tools and intervention guidelines could further improve outcomes for patients undergoing CABG.
This research underscored the growing recognition of holistic patient management in cardiovascular surgery, positioning PNI scores as a critical tool in clinical decision-making. The integration of nutritional care strategies could hold promise for enhancing recovery protocols and improving long-term survival rates among patients with coronary artery disease undergoing surgical intervention.
The study disclosed no competing interests.
