The effect of nutritional status on clinical outcome in lung transplantation.

ABSTRACT

BACKGROUND AND OBJECTIVES: Nutritional status greatly impacts the clinical outcome of the patients receiving lung transplantation. The objective of this study was to evaluate the effect of nutritional status on the clinical outcome in lung transplant recipients. METHODS AND STUDY DESIGN: A single-center retrospective study was conducted including 73 patients received lung transplantation from December 2015 to April 2022 in the Affiliated Henan Provincial People's Hospital of Zhengzhou University. Data were collected from the hospital information system. The records of BMI, malnutrition defined by the Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria, hemoglobin and plasma albumin before operation were accessed. The primary outcome assessed was survival or mortality represented by Kaplan-Meier survival curves; the log-rank test and multivariate Cox proportional hazards regression were used to evaluate the influence of each factor on survival. RESULTS: Kaplan-Meier survival analysis showed that malnutrition, hemoglobin and plasma albumin were predictors of survival in lung transplantation (Log Rank p<0.05). Multivariate Cox regression showed that pre-operative hemoglobin <130 g/L (HR 2.532, p=0.036) and plasma albumin <35 g/L (HR 2.723, p=0.016) were associated with the decreased survival rate. CONCLUSIONS: Preoperative anemia and hypoalbuminemia increase the mortality risk of the lung transplantation patients. Pre-operative nutrition support, therefore, is likely to be critical for improving clinical outcome in patients undergoing lung transplantation.