Authors

• Mijana Barišic — Thalassotherapia Opatija – Clinic for treatment, rehabilitation and prevention of cardiovascular disease, Opatija, Croatia — ORCID: 0000-0001-5774-7488
• Viktor Peršic — Thalassotherapia Opatija – Clinic for treatment, rehabilitation and prevention of cardiovascular disease, Opatija, Croatia — ORCID: 0000-0003-4473-5431
• Damir Raljevic — Thalassotherapia Opatija – Clinic for treatment, rehabilitation and prevention of cardiovascular disease, Opatija, Croatia — ORCID: 0000-0001-9743-9201
• Marica Komošar-Cvetkovic — Thalassotherapia Opatija – Clinic for treatment, rehabilitation and prevention of cardiovascular disease, Opatija, Croatia — ORCID: 0000-0002-9539-9733
• Aleksandar Vcev — Josip Juraj Strossmayer University of Osijek School of Medicine, University Hospital Centre Osijek, Osijek, Croatia
• Marko Boban — Thalassotherapia Opatija – Clinic for treatment, rehabilitation and prevention of cardiovascular disease, Opatija, Croatia — ORCID: 0000-0002-6129-575X

Abstract

Introduction: Major invasive treatment, like cardiac surgery leads to muscle weakness, unintentional weight loss and increased nutritional risk. (1-3) The aim of our study was to assess these parameters in patients scheduled for cardiac rehabilitation after recent heart surgery, depending on the existence of diabetes mellitus. Patients and Metods: Prospective study that included patients with diabetes scheduled for rehabilitation within one month from surgical procedure, and control number of peers without diabetes. Assessment included anthropometric measurement, hand grip test (HGT), weight lost history (WLH) and standardized NRS-2002 screening tool. Results: There were 59 patients of the mean age 67.0 years, male to female ratio was 48:11 (81%:19%) respectively. Diabetes mellitus was present in 26 (44%). Diabetic vs. non diabetic had 28.7kg vs. 33.5kg for left hand HGT; 29.5kg vs. 38.0kg for right hand HGT; %WLH was 6.7% vs. 6.8%; and NRS-2002 was 3.6 vs. 3.4, respectively. Conclusion: Both groups of patients expressed similarly pronounced nutritional risk after heart surgery, measured by mean %WLH and NRS-2002. However, a significant difference in strength of HGT implies that metabolic perturbations after surgery cause more severe muscle dysfunction in diabetics, in comparison with non-diabetics. This should be taken in to count for individualization of therapeutic approach in cardiovascular rehabilitation process.

Keywords

cardiac rehabilitation, hand grip test, nutritional risk screening, unintentional loss of weight

DOI

Literature

1. Kondrup J, Allison SP, Elia M, Vellas B, Plauth M, Educational and Clinical Practice Committee. European Society of Parenteral and Enteral Nutrition (ESPEN). ESPEN guidelines for nutrition screening 2002. Clin Nutr. 2003;22(4):415–21. https://doi.org/10.1016/S0261-5614(03)00098-0
2. Boban M, Laviano A, Persic V, Rotim A, Jovanovic Z, Vcev A. Characteristics of NRS-2002 Nutritional Risk Screening in patients hospitalized for secondary cardiovascular prevention and rehabilitation. J Am Coll Nutr. 2014;33(6):466–73. https://doi.org/10.1080/07315724.2013.876902
3. Boban M, Persic V, Miletic B, Kovacicek K, Madzar Z. Heart surgery stems increased nutritional risk, expressed during the course of stationary rehabilitation. Ann Nutr Metab. 2013;63(1-2):17–24. https://doi.org/10.1159/000350044