Metabolism and Nutrition Disorders Clinical Trial
Official title:
The CoCoS Interventional Trial: Caloric Control in Cardiac Surgery Patients
Background: Malnutrition is widespread among cardiac surgery patients and is independently
related to an adverse postoperative evolution or outcome. The investigators aimed to assess
whether nutrition therapy (NT) could alter caloric deficit, morbidity, and mortality in
patients scheduled for non-emergency coronary artery bypass graft (CABG) or aortic valve
surgery.
Methods: 351 patients undergoing either elective CABG or aortic valve surgery were studied.
Patients receiving NT were enrolled from January 2013 until December 2014. A historical
control group consisted of 142 matched patients. Preoperative nutritional status was
evaluated. Resting energy expenditure was measured using indirect calorimetry or calculated.
Caloric intake and caloric deficits were assessed. The primary endpoint was to evaluate
whether NT could limit caloric deficit (Intake to Need Deviation). A secondary endpoint
addressed the potential effect of NT on morbidity and mortality. Patients were followed for
one year after surgery.
Background: Malnutrition, often presenting as sarcopenic obesity, is widespread among
cardiac surgery patients and is independently related to an adverse postoperative evolution
or outcome. Nutritional status and energetic needs or deficits in cardiac surgery patients
are poorly documented and undernutrition, though readily modifiable, is an often overlooked
condition during hospitalization. The investigators aimed to assess whether nutrition
therapy (NT) could alter caloric deficit, morbidity, and mortality in patients scheduled for
non-emergency coronary artery bypass graft (CABG) or aortic valve surgery.
Methods: 351 patients undergoing either elective CABG or aortic valve surgery were studied.
Patients receiving NT were enrolled from January 2013 until December 2014. A historical
control group consisted of 142 matched patients who underwent either type of surgery. In all
patients, the NRS 2002 and MUST score were used for evaluating the preoperative nutritional
status. Resting energy expenditure was measured using indirect calorimetry or calculated. A
dietician assessed daily caloric intake during the entire hospitalization. Caloric deficits
were calculated. According to a predefined flow-chart protocol, nutritional interventions
were launched on different time points. Interventions varied from nutritional modifications
to oral supplementation, tube feeding, and parenteral nutrition. The primary endpoint was to
evaluate whether NT could limit caloric deficit (Intake to Need Deviation). A secondary
endpoint addressed the potential effect of NT on morbidity and mortality. Patients were
followed for one year after surgery.
;
Allocation: Non-Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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