Inflammation, functional status, and weight loss during recovery from cardiac surgery in older adults: A pilot study

Rose Ann DiMaria-Ghalili, Eileen M. Sullivan-Marx, Charlene Compher

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)344-352
Number of pages9
JournalBiological Research for Nursing
Volume16
Issue number3
DOIs
StatePublished - 2014

Keywords

  • Cardiac surgery
  • Hand-grip strength
  • IL-6
  • MNA
  • Timed chair stand
  • Weight loss

ASJC Scopus subject areas

  • Research and Theory

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