Rose Ann DiMaria-Ghalili1. 1. West Virginia University, School of Nursing, Charleston Division, 25304, USA. rdimaria@hsc.wvu.edu
Abstract
OBJECTIVES: To systematically examine the pattern of nutritional status over time in older people undergoing elective coronary artery bypass grafting (CABG) and the extent to which nutritional status affects health outcomes postdischarge. DESIGN: The sample consisted of 91 community-dwelling English-speaking persons > or = 65 (72.27 +/- 4.85) years of age with normal cognitive function and no active cancer. Data collected prospectively at 3 time points (preoperatively, postoperatively on day 5, and 4 to 6 weeks postdischarge) included serum albumin, transferrin, and calculated Body Mass Index (BMI). The Short-Form 36 Health Status Survey Questionnaire was administered 4 to 6 weeks postdischarge as a primary health outcome measure. RESULTS: Nutritional status changed over time. For albumin and transferrin, the pattern of change corresponded to the phases of surgical stress (P = 0.001). The BMI decreased from preoperative to 4 to 6 weeks postdischarge (P = 0.001), and this decrease explained 13.8% of the variance in physical health 4 to 6 weeks postdischarge (P = 0.008). The change in the BMI corresponds to an average weight loss of 5% from preoperative to postdischarge. CONCLUSIONS: Older people undergoing CABG who lose significant weight from preoperative to postdischarge are more likely to have lower self-reported physical health.
OBJECTIVES: To systematically examine the pattern of nutritional status over time in older people undergoing elective coronary artery bypass grafting (CABG) and the extent to which nutritional status affects health outcomes postdischarge. DESIGN: The sample consisted of 91 community-dwelling English-speaking persons > or = 65 (72.27 +/- 4.85) years of age with normal cognitive function and no active cancer. Data collected prospectively at 3 time points (preoperatively, postoperatively on day 5, and 4 to 6 weeks postdischarge) included serum albumin, transferrin, and calculated Body Mass Index (BMI). The Short-Form 36 Health Status Survey Questionnaire was administered 4 to 6 weeks postdischarge as a primary health outcome measure. RESULTS: Nutritional status changed over time. For albumin and transferrin, the pattern of change corresponded to the phases of surgical stress (P = 0.001). The BMI decreased from preoperative to 4 to 6 weeks postdischarge (P = 0.001), and this decrease explained 13.8% of the variance in physical health 4 to 6 weeks postdischarge (P = 0.008). The change in the BMI corresponds to an average weight loss of 5% from preoperative to postdischarge. CONCLUSIONS: Older people undergoing CABG who lose significant weight from preoperative to postdischarge are more likely to have lower self-reported physical health.