Preoperative nutritional status as a predictor of postoperative fatigue in patients undergoing cardiac or vascular surgery

Participants in the study were cardiac and vascular surgical patients admitted in the elective or acute setting at a tertiary public hospital (Waikato Hospital, New Zealand) between December 2008 and February 2009. Prior to surgery included participants completed two questionnaires: the Mini Nutritional Assessment (MNA) questionnaire and the Identity Consequences Fatigue Score (ICFS) questionnaire. The duration of observation was from surgical admission until 6 months post operatively. The MNA questionnaire was used to screen for preoperative nutritional status and consisted of two sections: screening and assessment. Using a scoring system, the screening section assessed loss of appetite, weight loss, mobility, psychological stress, acute disease, neuropsychological problems and BMI. Patients were then allocated into “normal” and “possible malnutrition” subgroups. If classified as “possible malnutrition”, then the patient would complete a more detailed assessment section evaluating their dietary history, and psychosocial and health status, including both mid- arm and calf circumferences. The ICFS measured self-reports of patient fatigue and, following preoperative completion, was then posted to participants for self-completion at 2 and 6 months postoperatively. Patients were contacted by phone to ensure receipt of questionnaires and a reminder phone call was conducted if a completed questionnaire was not received within a week, through a pre-paid envelope provided.