• Masato Ogawa, Kazuhiro P Izawa, Seimi Satomi-Kobayashi, Aki Kitamura, Rei Ono, Yoshitada Sakai, and Yutaka Okita.
• Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan.
• Aging Clin Exp Res. 2017 Apr 1; 29 (2): 283-290.

BackgroundPreoperative nutritional status and physical function are important predictors of mortality and morbidity after cardiac surgery. However, the influence of nutritional status before cardiac surgery on physical function and the progress of postoperative rehabilitation requires clarification.AimsTo determine the effect of preoperative nutritional status on preoperative physical function and progress of rehabilitation after elective cardiac surgery.MethodsWe enrolled 131 elderly patients with mean age of 73.7 ± 5.8 years undergoing cardiac surgery. We divided them into two groups by nutritional status as measured by the Geriatric Nutritional Risk Index (GNRI): high GNRI group (GNRI ≥ 92, n = 106) and low GNRI group (GNRI < 92, n = 25). Physical function was estimated by handgrip strength, knee extensor muscle strength (KEMS), the Short Physical Performance Battery (SPPB), and 6-minute walk test (6MWT). Progress of postoperative rehabilitation was evaluated by the number of days to independent walking after surgery, length of stay in the ICU, and length of hospital stay.ResultsAfter adjusting for potential confounding factors, preoperative handgrip strength (P = 0.034), KEMS (P = 0.009), SPPB (P < 0.0001), and 6MWT (P = 0.012) were all significantly better in the high GNRI group. Multiple regression analysis revealed that a low GNRI was an independent predictor of the retardation of postoperative rehabilitation.ConclusionsPreoperative nutritional status as assessed by the GNRI could reflect perioperative physical function. Preoperative poor nutritional status may be an independent predictor of the retardation of postoperative rehabilitation in patients undergoing elective cardiac surgery.

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