According to a new study, patients who are at risk for malnutrition when undergoing heart surgery can now be more easily identified leading to better intervention and improved surgical outcomes. The study is published in The Annals of Thoracic Surgery.
Malnutrition during the post-operative period can lead to high morbidity and mortality as well as delayed recovery, increased hospital stay, early readmission, decreased quality of life and increased healthcare costs. Several days can pass by before clinicians realise that the reason behind the slow recovery is due to the lack of nutritional support. This particular study offers a nutrition risk store that is able to heighten sensitivity to patients who may need nutritional support.
Researchers identifed 1056 adult open heart surgery patients. 87% of these patients required post-operative nutritional support. These same patients were also more likely to have diabetes and chronic obstructive pulmonary disease.
A JHH Nutrition Score (JHH NS) was developed by the research team. It was generated by seven variables such as prior cardiac interventions, white blood cell count, urgent/emergent operation status and others. Each variable was allocated a number if it was abnormal. High scores indicated that the patient may be in need of nutritional support.
As senior author Glenn Whitman, MD, of Johns Hopkins Hospital (JHH) in Baltimore, Md explains, this risk score serves as a screening tool to determine which patients are low or high risk for needing nutritional support. The total point score enables clinicians to better determine when nutritional support should start in certain patients.
The JHH NS scores were applied to 1,136 patients who underwent heart surgery. These scores strongly correlated to the patients who required postoperative nutritional support.
“In using the JHH Nutrition Score to accurately identify the at-risk patients and then aggressively pursuing nutrition support, we may improve substantially upon their current poor outcomes,” said Dr. Whitman. “Individualised nutrition strategies, combined with the expertise of the nutrition support team and the clinical approach of the caregiver, may further enhance the management of these patients.”
Image Credit: Johns Hopkins Hospital