骨動脈弁置換手術を受けた弱体と弱体でない高齢者の栄養不良と死亡率
Michael Goldfarb1, Sandra Lauck2, John G Webb2
1Azrieli Heart Centre (M.G., L.G.R., J.A.), Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Circulation
|July 7, 2018
まとめ
栄養不良は,大動脈弁置換 (AVR) を受けている高齢者の1年間の死亡リスクを大幅に増加させます. 栄養状態は結果の重要な予測要因であり,介入の必要性を強調しています.
科学分野:
- 心臓病科
- 高齢者医療
- 栄養学
背景:
- 大動脈弁置換 (AVR) を 受けている高齢者は 栄養不良のリスクに直面します
- 処置前の栄養状態とAVR後の中期死亡率との関連は十分に確立されていません.
研究 の 目的:
- 治療前の栄養状態と1年間の死亡率との関連を調査する.
- AVR の後の短期的および中期的な結果を予測する栄養状態の価値を評価する.
主な方法:
- FRAILTY- AVRの将来性多センターコホート研究では,トランスキャセターまたは手術によるAVRを受けた患者1158人 (≥70歳) が参加しました.
- 栄養状態はミニ栄養評価-ショートフォーム (MNA-SF) を用いて評価され,脆弱性はショート・パフォーマンス・フィジカル・バッテリーで測定された.
- 多変数回帰モデルを使用して,プライマリアウトカム (1年全因死亡率) と二次アウトカム (30日複合死亡率/罹病率) を分析した.
主要な成果:
- 8. 7% の患者は栄養失調で, 32. 8% は栄養失調のリスクがありました.
- 栄養不良の患者は,1年後の死亡率のほぼ3倍 (28% vs 10%) であった.
- 処置前の栄養状態は,1年後の死亡率 (MNA- SFポイントあたりOR1. 08) と調整後の30日間の複合アウトカム (MNA- SFポイントあたりOR1. 06) を独立に予測した.
結論:
- 治療前の栄養状態は,AVRを受けた高齢者の死亡率と有意に関連しています.
- 栄養状態はAVR後の中期的な死亡率と短期的な安全性双方の予測要因です.
- この患者群のアウトカムを改善するための栄養介入の有効性を評価するために,さらなる臨床試験が必要である.
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