Nutrition (Burbank, Los Angeles County, Calif.) · 2026
Perioperative immunonutrition reduces infections and hospital stay in older patients undergoing elective cardiac surgery.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Gonçalves Thiago J M, Gonçalves Sandra E A B, de Castro Marcelo M, de Carvalho Felipe L, de Souza Mayara S, Castro Alessandra A S, da Cunha Marcos P, Berlinck Marcos F
Аннотация
OBJECTIVES: This study aimed to evaluate whether perioperative oral nutritional supplementation (ONS) with immunonutrients improves clinical and surgical outcomes, including 30-day infection and surgical wound dehiscence, in older patients undergoing elective open cardiac surgery.
METHODS: This retrospective observational cohort study included older patients undergoing elective open myocardial revascularization between 2015 and 2021. The immunonutrition (IM) group (n = 236) received ONS with immunonutrients for 5 days preoperatively and 5 days postoperatively. The control group (n = 232) received standard nutritional guidance only. Primary endpoints included length of stay (LOS), C-reactive protein (CRP) levels on the third postoperative day (POD), and 30-day infectious complications.
RESULTS: The IM group demonstrated a significantly shorter mean operative time compared to the control group (186.2 versus 218.7 min; P < 0.001). Postoperatively, the IM group had significantly lower CRP levels on POD 3 (98.8 versus 147.0 mg/dL; P < 0.001) and a shorter LOS (5.5 versus 8.1 days; P < 0.001). Most notably, the incidence of 30-day infections was significantly lower in the IM group compared to control (3.8% versus 15.5%; P < 0.001). Also, the IM group reduced the odds of infectious complications by 78% (odds ratio [OR], 0.22; 95% CI: 0.10-0.47; P < 0.001). There was also a reduction in the incidence of surgical site dehiscence (0.4% versus 3.4%; P = 0.041).
CONCLUSIONS: Implementing a perioperative immunonutrition protocol for older patients undergoing elective cardiac surgery may be associated with reduced systemic inflammation, shorter hospital stays, and a significant decrease in postoperative infectious complications.
METHODS: This retrospective observational cohort study included older patients undergoing elective open myocardial revascularization between 2015 and 2021. The immunonutrition (IM) group (n = 236) received ONS with immunonutrients for 5 days preoperatively and 5 days postoperatively. The control group (n = 232) received standard nutritional guidance only. Primary endpoints included length of stay (LOS), C-reactive protein (CRP) levels on the third postoperative day (POD), and 30-day infectious complications.
RESULTS: The IM group demonstrated a significantly shorter mean operative time compared to the control group (186.2 versus 218.7 min; P < 0.001). Postoperatively, the IM group had significantly lower CRP levels on POD 3 (98.8 versus 147.0 mg/dL; P < 0.001) and a shorter LOS (5.5 versus 8.1 days; P < 0.001). Most notably, the incidence of 30-day infections was significantly lower in the IM group compared to control (3.8% versus 15.5%; P < 0.001). Also, the IM group reduced the odds of infectious complications by 78% (odds ratio [OR], 0.22; 95% CI: 0.10-0.47; P < 0.001). There was also a reduction in the incidence of surgical site dehiscence (0.4% versus 3.4%; P = 0.041).
CONCLUSIONS: Implementing a perioperative immunonutrition protocol for older patients undergoing elective cardiac surgery may be associated with reduced systemic inflammation, shorter hospital stays, and a significant decrease in postoperative infectious complications.