Abstract
Background: Postoperative cardiac surgery patients often experience appetite loss. Although nutritional status is known to be associated with time of recovery, functional status, and length of stay, less is known about factors related to patient’s loss of appetite after cardiac surgery. This review aimed to identify and understand factors related to loss of appetite in postoperative cardiac surgery patients, systematic review with narrative summary design was applied. Data sources including CINAHL, SCOPUS, PubMed, ProQuest, ScienceDirect, ThaiLIS, ThaiJo, and E-Thesis were searched without restriction on publication year through August 2020. Methods: We conducted the review following the Joanna Briggs Institute methodology, using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist to categorize methodological quality and the PRISMA flow diagram to record the studies’ factors. Results: Six studies reported one or more of 16 factors related to loss of appetite: older age, sex (female), illiteracy, history of chronic disease, not knowing someone in health field, pain score ≥ 7, pain medications containing codeine, constipation, depression, heart-lung machine ≥ 120 minutes, preoperative serum creatinine levels ≥ 179 µmol/L, emergency surgery, perfusion pressure ≤ 40 mmHg, low cardiac output syndrome, mechanical ventilation ≥ 96 hours, and a New York Heart Association class III and IV. Conclusion: The small number of publications restrict our conclusions. Future research should focus on multiple factors related to appetite loss in postoperative cardiac surgery patients. Additional research will provide a foundation for evidence-based interventions to reduce appetite loss and improve patient nutritional status after cardiac surgery. Nurses and other health professionals should assess postoperative cardiac surgery patients for the presence of the 16 significant factors. To promote patients’ nutritional status, there should be evidence-based practice guidelines on the management of postoperative symptoms such as pain management, treatment of constipation, and reduction of emotional stress and depression.
Highlights
Heart disease is one of the leading causes of death in both developed and developing countries[1]
The search strategy used the keywords “cardiac surgery” OR “open-heart surgery” AND “poor appetite” OR “loss of appetite” OR “decreased appetite” OR “change in appetite” OR “anorexia.” The selection of studies was made based on the following inclusion criteria: (a) research in humans related to cardiac surgery; (b) results about factors related to loss of appetite in postoperative cardiac surgery patients; (c) patients aged 18 years and older; and (d) published in the English or Thai language
We found that there were 16 factors related to loss of appetite in cardiac surgery patients
Summary
Heart disease is one of the leading causes of death in both developed and developing countries[1]. There are various types of cardiac surgery These include coronary artery bypass graft, valve replacement and repair, great vessel surgery, and septum repair for those with congenital heart disease. Results: Six studies reported one or more of 16 factors related to loss of appetite: older age, sex (female), illiteracy, history of chronic disease, not knowing someone in health field, pain score ≥ 7, pain medications containing codeine, constipation, depression, heart-lung machine ≥ 120 minutes, preoperative serum creatinine levels ≥ 179 μmol/L, emergency surgery, perfusion pressure ≤ 40 mmHg, low cardiac output syndrome, mechanical ventilation ≥ 96 hours, and a. Cardiac surgery intensifies catabolism and insulin resistance, resulting in higher blood sugar levels in both patients with and without a history of diabetes[6] These factors directly and indirectly disturb the postoperative physiological/psychological interconnections to produce a loss of appetite and a nutritional imbalance[7]
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