Influence of preoperative nutritional status on postoperative dysphagia in lung transplantation

The purpose of this study is to determine the effect of preoperative nutritional status on the severity of postoperative dysphagia in recipients undergoing lung transplantation (LTx).

A retrospective analysis was conducted. Preoperative nutritional status was assessed using the Controlling Nutritional Status (CONUT) score and the Global Leadership Initiative on Malnutrition (GLIM) criteria. Dysphagia on postoperative day 14 was evaluated using the Functional Oral Intake Scale (FOIS). Study variables included age, sex, type of LTx, duration of intensive care unit stay, duration of mechanical ventilation use, duration of surgery, tracheostomy, extracorporeal membrane oxygen therapy (ECMO), pulmonary arterial hypertension (PAH), CONUT score, and GLIM criteria. Binary logistic regression (BLR) was used to assess independent factors.

Among 65 recipients (31 females, mean age 43.4 ± 12.0 years), postoperative dysphagia (n = 39) was associated with younger age (P < 0.001), female sex (P = 0.026), double LTx (P < 0.001), longer ICU stay (P < 0.001), longer mechanical ventilation use (P < 0.001), longer duration of surgery (P < 0.001), need of tracheostomy (P < 0.001), use of ECMO (P < 0.001), PAH diagnosis (P = 0.005), higher CONUT score (P < 0.001), and malnutrition by GLIM criteria (P = 0.031). Preoperative CONUT score was the only independent factor by BLR (P = 0.026, OR = 0.221, 95% CI: 0.059-0.837).

Our findings suggest that preoperative nutritional status may be important for the preservation of postoperative swallowing function in LTx.