Abstract

Objective: Malnutrition in patients undergoing left ventricular assist device (LVAD) implantation has negative consequences, such as infection and limited functional capacity. The effects of nutritional status of patients with LVAD on their clinical outcomes were investigated.

Methods: Patients with LVAD implantation were retrospectively analyzed. For nutritional evaluation, nutrition risk score NRI score was calculated to divide the patients first into two groups with and without malnutrition risk (MR) then three subgroups (mild/moderate/severe) according to malnutrition risk. Demographic and clinical data before LVAD, early postoperative adverse events after LVAD, prognostic data, and laboratory findings were analyzed.

Results: Sixty patients (9 females) had a mean age of 46.1±14.3 years; mean NRI score was 99.6±10.2. Interagency Registry for Mechanically Assited Circulatory Support (INTERMACS) scores were determined as 1 (n=10), 2 (n=18), 3 (n=11), and 4 (n=21). Thirty-two patients (53.3%) (6 mild, 25 moderate, 1 severe) had MR. The MR was higher in patients with preoperative INTERMACS score 1, acute renal injury (AKI), emergency LVAD indication, mechanical ventilation (MV) and preoperative ICU requirement. The incidence of adverse events was found to be significantly higher in patients with low-grade NRI and early postoperative MR. Postoperatively, the duration of renal replacement therapy (RRT), MV, ICU and hospital stay and the need for heart transplantation and mortality did not differ between the two groups.

Conclusion: In the early postoperative period, a MR of 53.3% was detected in patients who underwent LVAD. Total 68.8% patients had adverse events. We found that the presence of MR was effective in predicting postoperative adverse events according to NRI score before LVAD treatment.

Keywords: Intensive care unit, left ventricular assist device treatment, malnutrition risk, NRI scoring system