Preoperative Protein and Energy Intake and Postoperative Complications in Well-nourished, Non-hospitalized Elderly Cardiac Surgery Patients

Background & Aims: Little is known about the impact of preoperative protein or energy intake in relation to the occurrence of postoperative complications in patients who are not undernourished but cannot keep up their daily protein or energy requirements prior to cardiac surgery. Therefore, a prospective study on intake in preoperatively well-nourished, non-hospitalized cardiac surgery patients (>or= 65 y) was carried out.

Methods: Between December 2004 and November 2005 preoperative protein and energy intake and postoperative outcome data were collected from 100 consecutive patients undergoing cardiac surgery.

Results: Comparison of low protein intake (<or= 0.98 g/kg/d) with high protein intake (>0.98 g/kg/d) showed a low protein intake did not result in more complications or prolonged length of stay. In low-risk operation patients in particular, a high-energy intake (>22 kcal/kg/d) resulted in more postoperative complications than a low energy intake (<or= 22 kcal/kg/d) (33.3% and 13.2%, respectively; (OR 5.0 95% CI [1.5-16.9])). A preoperative protein intake <or= 0.80 g/kg/d was seen in 22.6%, and an energy intake <or= 25 kcal/kg/d in 72.2% of the patients.

Conclusion: The outcome of this study suggests that detecting and correcting a preoperative low protein or energy intake is of no clinical relevance in the well-nourished, non-hospitalized elderly cardiac surgery patients. Caloric overfeeding may be associated with an increased complication rate.