TY - JOUR
T1 - Inflammation, functional status, and weight loss during recovery from cardiac surgery in older adults
T2 - A pilot study
AU - DiMaria-Ghalili, Rose Ann
AU - Sullivan-Marx, Eileen M.
AU - Compher, Charlene
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: The project was funded by the American Academy of Nursing Building Academic Geriatric Capacity Fellowship Program; and the National Center for Research Resources Grant Number UL1RR024134 from the National Institutes of Health’s National Center for Research Resources. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health.
PY - 2014/7
Y1 - 2014/7
N2 - Objective: To determine the nutritional, inflammatory, and functional aspects of unintentional weight loss after cardiac surgery that warrant further investigation. Research Methods and Procedures: Twenty community-dwelling adults ≥ 65 years old undergoing cardiac surgery (coronary artery bypass graft [CABG] or CABG + valve) were recruited for this prospective longitudinal (preoperative and 4-6 weeks postdischarge) pilot study. Anthropometrics (weight, standing height, and mid-arm and calf circumference), nutritional status (Mini-Nutritional Assessment™ [MNA]), appetite, physical performance (timed chair stand), muscle strength (hand grip) and functional status (basic and instrumental activities of daily living), and inflammatory markers (plasma leptin, ghrelin, interleukin [IL]-6, high-sensitivity[hs] C-reactive protein, and serum albumin and prealbumin) were measured. Results: Participants who completed the study (n = 11 males, n = 3 females) had a mean age 70.21 ± 4.02 years. Of these, 12 lost 3.66 ± 1.44 kg over the study period. Weight, BMI, activities of daily living, and leptin decreased over time (p <.05). IL-6 increased over time (p <.05). Ghrelin, hs-CRP, and timed chair stand increased over time in those who underwent combined procedures (p <.05). Grip strength decreased in those who developed complications (p =.004). Complications, readmission status, and lowered grip strength were found in those with low preoperative MNA scores (p <.05). Conclusion: After cardiac surgery, postdischarge weight loss occurs during a continued inflammatory response accompanied by decreased physical functioning and may not be a positive outcome. The impacts of weight loss, functional impairment, and inflammation during recovery on disability and frailty warrant further study.
AB - Objective: To determine the nutritional, inflammatory, and functional aspects of unintentional weight loss after cardiac surgery that warrant further investigation. Research Methods and Procedures: Twenty community-dwelling adults ≥ 65 years old undergoing cardiac surgery (coronary artery bypass graft [CABG] or CABG + valve) were recruited for this prospective longitudinal (preoperative and 4-6 weeks postdischarge) pilot study. Anthropometrics (weight, standing height, and mid-arm and calf circumference), nutritional status (Mini-Nutritional Assessment™ [MNA]), appetite, physical performance (timed chair stand), muscle strength (hand grip) and functional status (basic and instrumental activities of daily living), and inflammatory markers (plasma leptin, ghrelin, interleukin [IL]-6, high-sensitivity[hs] C-reactive protein, and serum albumin and prealbumin) were measured. Results: Participants who completed the study (n = 11 males, n = 3 females) had a mean age 70.21 ± 4.02 years. Of these, 12 lost 3.66 ± 1.44 kg over the study period. Weight, BMI, activities of daily living, and leptin decreased over time (p <.05). IL-6 increased over time (p <.05). Ghrelin, hs-CRP, and timed chair stand increased over time in those who underwent combined procedures (p <.05). Grip strength decreased in those who developed complications (p =.004). Complications, readmission status, and lowered grip strength were found in those with low preoperative MNA scores (p <.05). Conclusion: After cardiac surgery, postdischarge weight loss occurs during a continued inflammatory response accompanied by decreased physical functioning and may not be a positive outcome. The impacts of weight loss, functional impairment, and inflammation during recovery on disability and frailty warrant further study.
KW - Cardiac surgery
KW - Hand-grip strength
KW - IL-6
KW - MNA
KW - Timed chair stand
KW - Weight loss
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U2 - 10.1177/1099800413503489
DO - 10.1177/1099800413503489
M3 - Article
C2 - 24057224
AN - SCOPUS:84904996426
SN - 1099-8004
VL - 16
SP - 344
EP - 352
JO - Biological Research for Nursing
JF - Biological Research for Nursing
IS - 3
ER -