Índice de pronóstico nutricional como marcador en pacientes de cirúrgico cardíaca: una revisión sistemática

Autores/as

DOI:

https://doi.org/10.33448/rsd-v11i9.32106

Palabras clave:

Complicaciones Intraoperatorias; Cirugía Torácica; Enfermedades cardíacas; Estado Nutricional; Índice pronóstico nutricional.

Resumen

Introducción: Los avances tecnológicos y los nuevos métodos quirúrgicos han sido insuficientes para reducir el alto riesgo de mortalidad y morbilidad en pacientes sometidos a cirugía cardiaca. Se sabe que la desnutrición preoperatoria se correlaciona con la morbilidad, mortalidad, ingreso hospitalario y calidad de vida después de la cirugía. El índice de pronóstico nutricional (NPI) se calcula a partir de los niveles de albúmina sérica y los recuentos de linfocitos periféricos. Los estudios han demostrado que un NPI bajo es un factor pronóstico adverso independiente a corto y largo plazo. Objetivo: Evaluar si el índice pronóstico nutricional es un buen marcador pronóstico para predecir complicaciones y muerte en pacientes quirúrgicos cardíacos. Metodología: Se realizó una revisión sistemática en las bases de datos PubMed, Lilacs y SciELO, con los siguientes descriptores: índice nutricional pronóstico y cardiaco y quirúrgico. Se eligieron artículos que evaluaran el NPI y las complicaciones, incluida la muerte, en pacientes quirúrgicos cardíacos. Resultados: Diecinueve publicaciones fueron analizadas e incluidas en la revisión sistemática, de las cuales 13 fueron estudios observacionales prospectivos y 6 estudios observacionales retrospectivos. De estos estudios, 9 fueron comparaciones con otros índices, 4 sobre NPI y complicaciones postoperatorias y 6 sobre NPI y mortalidad, la mayoría de los estudios demuestran que el NPI es una buena herramienta para señalar mortalidad y complicaciones postoperatorias. Conclusión: Los resultados sugieren que el IPN es una buena herramienta para señalar el riesgo de muerte y complicaciones en el postoperatorio de cirugías cardíacas, pero aún no se ha establecido un punto de corte común para la cirugía.

Citas

Açıkel, M. E. T., & Korkut, A. K. (2019). Impact of Controlling Nutritional Status Score (CONUT) and Prognostic Nutritional Index (PNI) on Patients Undergoing Coronary Artery Bypass Graft Surgery. The Heart Surgery Forum, 22(4), E294–E297. https://doi.org/10.1532/hsf.2493

Allard, J. P., Keller, H., Jeejeebhoy, K. N., Laporte, M., Duerksen, D. R., Gramlich, L., Payette, H., Bernier, P., Davidson, B., Teterina, A., & Lou, W. (2016). Decline in nutritional status is associated with prolonged length of stay in hospitalized patients admitted for 7 days or more: A prospective cohort study. Clinical Nutrition, 35(1), 144–152. https://doi.org/10.1016/j.clnu.2015.01.009

Bayram, Z., Efe, S. Ç., Karagöz, A., Doğan, C., Güvendi, B., Uysal, S., Akbal, Ö. Y., Yılmaz, F., Tokgöz, H. C., Acar, R. D., Kirali, M. K., Kaymaz, C., & Özdemir, N. (2022). Prognostic Impact of Nutritional Indices in Candidates for Heart Transplantation. Turk Kardiyoloji Dernegi Arsivi: Turk Kardiyoloji Derneginin Yayin Organidir, 50(2), 92–100. https://doi.org/10.5543/tkda.2022.21126

Birkmeyer, J. D., Stukel, T. A., Siewers, A. E., Goodney, P. P., Wennberg, D. E., & Lucas, F. L. (2003). Surgeon Volume and Operative Mortality in the United States. New England Journal of Medicine, 349(22), 2117–2127. https://doi.org/10.1056/NEJMsa035205

Buzby, G. P., Mullen, J. L., Matthews, D. C., Hobbs, C. L., & Rosato, E. F. (1980). Prognostic nutritional index in gastrointestinal surgery. The American Journal of Surgery, 139(1), 160–167. https://doi.org/10.1016/0002-9610(80)90246-9

Cai, Z., Tu, J., Xu, L., Lin, Y., Deng, B., Li, F., Chen, S., & Dong, N. (2022). Combining Prognostic Nutritional Index and Brain Natriuretic Peptide as a Predicting Tool for Heart Transplantation. Journal of Cardiovascular Development and Disease, 9(2), 40. https://doi.org/10.3390/jcdd9020040

Cho, J. S., Shim, J.-K., Kim, K.-S., Lee, S., & Kwak, Y.-L. (2021). Impact of preoperative nutritional scores on 1-year postoperative mortality in patients undergoing valvular heart surgery. The Journal of Thoracic and Cardiovascular Surgery, S0022-5223(20)33454-1. https://doi.org/10.1016/j.jtcvs.2020.12.099

Cooper, W. A., O’Brien, S. M., Thourani, V. H., Guyton, R. A., Bridges, C. R., Szczech, L. A., Petersen, R., & Peterson, E. D. (2006). Impact of Renal Dysfunction on Outcomes of Coronary Artery Bypass Surgery. Circulation, 113(8), 1063–1070. https://doi.org/10.1161/CIRCULATIONAHA.105.580084

Daly, L. E., Lonergan, M., & Graham, I. (1993). Predicting operative mortality after coronary artery bypass surgery in males. QJM: An International Journal of Medicine, 86(12), 771–778. https://doi.org/10.1093/oxfordjournals.qjmed.a068760

Felpel, K., Palmese, L., Urrutia, L., Zhang, Z., Shapero, M., Esbenshade, J., Hamid, S., & Vest, M. T. (2021). Nutritional assessment and comparison of nutritional indices in predicting adverse outcomes in patients undergoing left ventricular assist device implantation. Nutrition (Burbank, Los Angeles County, Calif.), 89, 111287. https://doi.org/10.1016/j.nut.2021.111287

Fortescue, E. B., Kahn, K., & Bates, D. W. (2001). Development and validation of a clinical prediction rule for major adverse outcomes in coronary bypass grafting∗∗A list of the members of the Academic Medical Center Consortium Quality Measurement and Management Initiative Working Group appears in the Appendix. The American Journal of Cardiology, 88(11), 1251–1258. https://doi.org/10.1016/S0002-9149(01)02086-0

Gucu, A., Ozluk, O. A., Guvenc, O., Sunbul, S. Ah., & Engin, M. (2021). The Importance of Prognostic Nutritional Index in Predicting Acute Renal Failure After On-Pump Coronary Artery Bypass Operations in Patients with Insulin-Dependent Diabetes Mellitus. The Heart Surgery Forum, 24(4), E651–E655. https://doi.org/10.1532/hsf.3859

Gucu, A., Ozluk, O. A., Sunbul, S. A., Engin, M., Seker, I. B., & Sunbul, A. (2021). Prognostic nutritional index as a marker of mortality: An observational cohort study of patients undergoing cardiac surgery. Reviews in Cardiovascular Medicine, 22(2), 499–503. https://doi.org/10.31083/j.rcm2202057

Gürbak, İ., Güner, A., Güler, A., Şahin, A. A., Çelik, Ö., Uzun, F., Onan, B., & Ertürk, M. (2021). Prognostic influence of objective nutritional indexes on mortality after surgical aortic valve replacement in elderly patients with severe aortic stenosis (from the nutrition-SAVR trial). Journal of Cardiac Surgery, 36(6), 1872–1881. https://doi.org/10.1111/jocs.15434

Hannan, E. L., Racz, M. J., Walford, G., Jones, R. H., Ryan, T. J., Bennett, E., Culliford, A. T., Isom, O. W., Gold, J. P., & Rose, E. A. (2005). Long-Term Outcomes of Coronary-Artery Bypass Grafting versus Stent Implantation. New England Journal of Medicine, 352(21), 2174–2183. https://doi.org/10.1056/NEJMoa040316

Hattler, B. G., Madia, C., Johnson, C., Armitage, J. M., Hardesty, R. L., Kormos, R. L., Pham, S. M., Payne, D. N., & Griffith, B. P. (1994). Risk stratification using the society of thoracic surgeons program. The Annals of Thoracic Surgery, 58(5), 1348–1352. https://doi.org/10.1016/0003-4975(94)91911-9

Hill, A., Nesterova, E., Lomivorotov, V., Efremov, S., Goetzenich, A., Benstoem, C., Zamyatin, M., Chourdakis, M., Heyland, D., & Stoppe, C. (2018). Current Evidence about Nutrition Support in Cardiac Surgery Patients—What Do We Know? Nutrients, 10(5), 597. https://doi.org/10.3390/nu10050597

Iwasa, M., Ogoshi, S., Kitagawa, S., Ohmori, Y., Iwasa, Y., Mizobuchi, S., Tamiya, T., & Isono, K. (1988). Effect of Preoperative Hyperalimentation for Patients with Esophageal Cancer and Usefulness of the Nutritional Assessment Index. Em J. R. Siewert & A. H. Hölscher (Orgs.), Diseases of the Esophagus (p. 264–267). Springer. https://doi.org/10.1007/978-3-642-86432-2_60

Jeon, H. G., Choi, D. K., Sung, H. H., Jeong, B. C., Seo, S. I., Jeon, S. S., Choi, H.-Y., & Lee, H. M. (2016). Preoperative Prognostic Nutritional Index is a Significant Predictor of Survival in Renal Cell Carcinoma Patients Undergoing Nephrectomy. Annals of Surgical Oncology, 23(1), 321–327. https://doi.org/10.1245/s10434-015-4614-0

Koch, C. G., Li, L., Kaplan, G. A., Wachterman, J., Shishehbor, M. H., Sabik, J., & Blackstone, E. H. (2010). Socioeconomic Position, Not Race, Is Linked to Death After Cardiac Surgery. Circulation: Cardiovascular Quality and Outcomes, 3(3), 267–276. https://doi.org/10.1161/CIRCOUTCOMES.109.880377

Kos, M., Titiz, H., Onec, B., Soysal, T., Kutlucan, A., Emen, S. S., & Kutlucan, L. (2016). Association of “controlling nutritional status index” and “prognostic nutritional index” with intensive care unit survival in elderly patients. European Geriatric Medicine, 7(1), 13–17.

Kucukosmanoglu, M., Kilic, S., Urgun, O. D., Sahin, S., Yildirim, A., Sen, O., & Kurt, İ. H. (2021). Impact of objective nutritional indexes on 1-year mortality after transcatheter aortic valve implantation: A prospective observational cohort study. Acta Cardiologica, 76(4), 402–409. https://doi.org/10.1080/00015385.2020.1747177

Kulier, A., Levin, J., Moser, R., Rumpold-Seitlinger, G., Tudor, I. C., Snyder-Ramos, S. A., Moehnle, P., & Mangano, D. T. (2007). Impact of Preoperative Anemia on Outcome in Patients Undergoing Coronary Artery Bypass Graft Surgery. Circulation, 116(5), 471–479. https://doi.org/10.1161/CIRCULATIONAHA.106.653501

Kurumisawa, S., & Kawahito, K. (2018). Risk analysis using the prognostic nutritional index in hemodialysis-dependent patients undergoing cardiac surgery. Journal of Artificial Organs: The Official Journal of the Japanese Society for Artificial Organs, 21(4), 443–449. https://doi.org/10.1007/s10047-018-1056-z

La Rovere, M. T., Maestri, R., Olmetti, F., Paganini, V., Riccardi, G., Riccardi, R., Pinna, G. D., & Traversi, E. (2017). Additional predictive value of nutritional status in the prognostic assessment of heart failure patients. Nutrition, Metabolism and Cardiovascular Diseases, 27(3), 274–280. https://doi.org/10.1016/j.numecd.2016.09.009

Larsson, J., Akerlind, I., Permerth, J., & Hörnqvist, J. O. (1994). The relation between nutritional state and quality of life in surgical patients. The European Journal of Surgery = Acta Chirurgica, 160(6–7), 329–334.

Lee, S. I., Ko, K.-P., Choi, C. H., Park, C.-H., Park, K. Y., & Son, K. H. (2020). Does the prognostic nutritional index have a predictive role in the outcomes of adult cardiac surgery? The Journal of Thoracic and Cardiovascular Surgery, 160(1), 145-153.e3. https://doi.org/10.1016/j.jtcvs.2019.08.069

Lin, Y., Chen, Q., Peng, Y., Chen, Y., Huang, X., Lin, L., Zhang, X., & Chen, L.-W. (2021). Prognostic nutritional index predicts in-hospital mortality in patients with acute type A aortic dissection. Heart & Lung: The Journal of Critical Care, 50(1), 159–164. https://doi.org/10.1016/j.hrtlng.2020.06.004

Lomivorotov, V. V., Efremov, S. M., Boboshko, V. A., Nikolaev, D. A., Vedernikov, P. E., Deryagin, M. N., Lomivorotov, V. N., & Karaskov, A. M. (2013). Prognostic value of nutritional screening tools for patients scheduled for cardiac surgery†. Interactive CardioVascular and Thoracic Surgery, 16(5), 612–618. https://doi.org/10.1093/icvts/ivs549

Lomivorotov, V. V., Efremov, S. M., Boboshko, V. A., Nikolaev, D. A., Vedernikov, P. E., Lomivorotov, V. N., & Karaskov, A. M. (2013). Evaluation of nutritional screening tools for patients scheduled for cardiac surgery. Nutrition, 29(2), 436–442. https://doi.org/10.1016/j.nut.2012.08.006

Mas-Peiro, S., Hoffmann, J., Seppelt, P. C., De Rosa, R., Murray, M.-I., Walther, T., Zeiher, A. M., Fichtlscherer, S., & Vasa-Nicotera, M. (2021). Value of prognostic nutritional index for survival prediction in trans-catheter aortic valve replacement compared to other common nutritional indexes. Acta Cardiologica, 76(6), 615–622. https://doi.org/10.1080/00015385.2020.1757854

Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. The BMJ, 339, b2535. https://doi.org/10.1136/bmj.b2535

Mori, S., Usami, N., Fukumoto, K., Mizuno, T., Kuroda, H., Sakakura, N., Yokoi, K., & Sakao, Y. (2015). The significance of the prognostic nutritional index in patients with completely resected non-small cell lung cancer. PloS one, 10(9), e0136897.

Nashef, S. A. M., Roques, F., Michel, P., Gauducheau, E., Lemeshow, S., Salamon, R., & the EuroSCORE study group. (1999). European system for cardiac operative risk evaluation (EuroSCORE). European Journal of Cardio-Thoracic Surgery, 16(1), 9–13. https://doi.org/10.1016/S1010-7940(99)00134-7

Öcal, L., Küp, A., Keskin, M., Cerşit, S., Çelik, M., Eren, H., Gürsoy, M. O., Öztürkeri, B., Öztürk, B., & Turkmen, M. M. (2020). Prognostic significance of pre-procedural prognostic nutritional index in patients with carotid artery stenting. Journal of Stroke and Cerebrovascular Diseases: The Official Journal of National Stroke Association, 29(8), 104932. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104932

O’Connor, G. T., Morton, J. R., Diehl, M. J., Olmstead, E. M., Coffin, L. H., Levy, D. G., Maloney, C. T., Plume, S. K., Nugent, W., & Malenka, D. J. (1993). Differences between men and women in hospital mortality associated with coronary artery bypass graft surgery. The Northern New England Cardiovascular Disease Study Group. Circulation, 88(5), 2104–2110. https://doi.org/10.1161/01.CIR.88.5.2104

Okada, S., Shimada, J., Kato, D., Tsunezuka, H., Teramukai, S., & Inoue, M. (2017). Clinical significance of prognostic nutritional index after surgical treatment in lung cancer. The Annals of thoracic surgery, 104(1), 296–302.

Okuno, T., Koseki, K., Nakanishi, T., Sato, K., Ninomiya, K., Tomii, D., Tanaka, T., Sato, Y., Horiuchi, Y., Koike, H., Yahagi, K., Komiyama, K., Tanaka, J., Aoki, J., Yokozuka, M., Miura, S., & Tanabe, K. (2019). Evaluation of objective nutritional indexes as predictors of one-year outcomes after transcatheter aortic valve implantation. Journal of Cardiology, 74(1), 34–39. https://doi.org/10.1016/j.jjcc.2019.02.017

Onodera, T., Goseki, N., & Kosaki, G. (1984). Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai Zasshi, 85(9), 1001–1005.

Panç, C., Yılmaz, E., Gürbak, İ., Uzun, F., & Ertürk, M. (2020). Effect of prognostic nutritional index on short-term survival after transcatheter aortic valve implantation. Turk Kardiyoloji Dernegi Arsivi: Turk Kardiyoloji Derneginin Yayin Organidir, 48(6), 585–593. https://doi.org/10.5543/tkda.2020.97709

Peng, D., Gong, Y., Hao, H., He, Z., Li, X., Zhang, C., & Zhou, L. (2017). Preoperative Prognostic Nutritional Index is a Significant Predictor of Survival with Bladder Cancer after Radical Cystectomy: A retrospective study. BMC Cancer, 17(1), 391. https://doi.org/10.1186/s12885-017-3372-8

Piggott, K. D., Liu, A., Monczka, J., Fakioglu, H., Narasimhulu, S. S., Pourmoghadam, K., & DeCampli, W. (2018). Inadequate preoperative nutrition might be associated with acute kidney injury and greater illness severity postoperatively. The Journal of Thoracic and Cardiovascular Surgery, 155(5), 2104–2109. https://doi.org/10.1016/j.jtcvs.2017.12.080

Ribeiro, A. L. P., Gagliardi, S. P. L., Nogueira, J. L. S., Silveira, L. M., Colosimo, E. A., & Nascimento, C. A. L. do. (2006). Mortality related to cardiac surgery in Brazil, 2000-2003. The Journal of Thoracic and Cardiovascular Surgery, 131(4), 907–909. https://doi.org/10.1016/j.jtcvs.2005.11.022

Stoppe, C., Goetzenich, A., Whitman, G., Ohkuma, R., Brown, T., Hatzakorzian, R., Kristof, A., Meybohm, P., Mechanick, J., Evans, A., Yeh, D., McDonald, B., Chourdakis, M., Jones, P., Barton, R., Tripathi, R., Elke, G., Liakopoulos, O., Agarwala, R., & Heyland, D. K. (2017). Role of nutrition support in adult cardiac surgery: A consensus statement from an International Multidisciplinary Expert Group on Nutrition in Cardiac Surgery. Critical Care, 21(1), 131. https://doi.org/10.1186/s13054-017-1690-5

Sun, K., Chen, S., Xu, J., Li, G., & He, Y. (2014). The prognostic significance of the prognostic nutritional index in cancer: A systematic review and meta-analysis. Journal of Cancer Research and Clinical Oncology, 140(9), 1537–1549. https://doi.org/10.1007/s00432-014-1714-3

Tasbulak, O., Guler, A., Duran, M., Sahin, A., Bulut, U., Avci, Y., Demir, A. R., Kahraman, S., Aydin, U., & Ertürk, M. (2021). Association Between Nutritional Indices and Long-Term Outcomes in Patients Undergoing Isolated Coronary Artery Bypass Grafting. Cureus, 13(7), e16567. https://doi.org/10.7759/cureus.16567

Tóth, K., Szabó, A., Menyhárd, J., Benke, K., Radovits, T., Pólos, M., Merkely, B., Gál, J., & Székely, A. (2022). Poor Preoperative Nutritional Status, but Not Hormone Levels, Are Associated With Mortality After Cardiac Surgery. Journal of Cardiothoracic and Vascular Anesthesia, 36(8 Pt B), 3074–3083. https://doi.org/10.1053/j.jvca.2022.04.035

Tranfield, D., Denyer, D., & Smart, P. (2003). Towards a methodology for developing evidence-informed management knowledge by means of systematic review. British Journal Management, 14,207-222. DOI: https://doi.org/10.1111/1467-8551.00375

Yost, G., Tatooles, A., & Bhat, G. (2018). Preoperative Nutritional Assessment with the Prognostic Nutrition Index in Patients Undergoing Left Ventricular Assist Device Implantation. ASAIO Journal (American Society for Artificial Internal Organs: 1992), 64(1), 52–55. https://doi.org/10.1097/MAT.0000000000000625

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16/07/2022

Cómo citar

QUEIROZ, B. G. S. S.; SANTOS, A. C. O. dos; SILVA, F. N. B. da .; ARRUDA, A. M. de; ALVES, J. F. N.; CAVALCANTE, . T. C. F.; SILVA, A. A. M. da. Índice de pronóstico nutricional como marcador en pacientes de cirúrgico cardíaca: una revisión sistemática. Research, Society and Development, [S. l.], v. 11, n. 9, p. e50611932106, 2022. DOI: 10.33448/rsd-v11i9.32106. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/32106. Acesso em: 22 dic. 2024.

Número

Vol. 11 Núm. 9

Sección

Ciencias de la salud

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Derechos de autor 2022 Barbara Giovanna Souza Silva Queiroz; Ana Célia Oliveira dos Santos; Fabiana Nogueira Benedito da Silva; Andressa Maranhão de Arruda; Juliana Fonseca Nogueira Alves; Taisy Cinthia Ferro Cavalcante; Amanda Alves Marcelino da Silva

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