Impact of Post–Cardiac Valve Replacement Surgery Nutrition on Recovery, Inflammation, And Quality of Life Among Cardiac Patients

Abstract

Background: After cardiac valve replacement surgery, there is a pronounced inflammatory response and heightened metabolic rate. The adequacy of nutrition may affect immune modulation, recovery parameters, and quality of life (QOL), but there is a paucity of combined prospective data.

Objective: To assess the effect of postoperative nutritional status on inflammation, recovery, and QOL in patients undergoing cardiac valve replacement surgery.

Materials and Methods: A prospective observational study was performed from January 2026 to March 2026 in a tertiary care cardiothoracic surgery unit. A total of 250 adult patients (18-80 years) undergoing elective aortic, mitral, or double valve replacement surgery were studied. Postoperative nutritional status was determined by dietary and biochemical parameters (calorie and protein intake, serum albumin, prealbumin, hemoglobin, vitamin D, and omega-3 fatty acid intake), and patients were classified as having adequate, moderate, or poor nutrition. Inflammatory response was measured by CRP levels (Day 1, Day 3, and Day 7). Recovery parameters included wound healing score, ejection fraction (EF), and ambulation time. QOL was measured by SF-36/WHOQOL-BREF questionnaires at baseline (discharge), 1 month, and 3 months. Statistical analysis included descriptive and comparative statistics using independent t-test/ANOVA, with p<0.05 considered significant.

Results: Mean age was 56.27 ± 12.74 years, with 133 (53.2%) male and 117 (46.8%) female patients. CRP values reduced in all nutritional groups from Day 1 to Day 7. In the adequate nutrition group, mean CRP reduced from 30.43 ± 12.51 (Day 1) to 21.03 ± 11.96 (Day 7). Comparison between adequate and poor nutrition groups revealed no statistically significant difference in CRP values on Day 1 (p=0.973), Day 3 (p=0.975), and Day 7 (p=0.937). Recovery rates were in favor of the adequate nutrition group, with higher wound healing score (7.50 ± 1.70 vs 7.02 ± 1.64, p=0.155), slightly higher EF (55.12 ± 5.83 vs 53.90 ± 5.76, p=0.329), and earlier ambulation (3.82 ± 1.42 vs 4.24 ± 1.51 days, p=0.228) compared with the poor nutrition group. QOL scores improved progressively in all groups; at 3 months, QOL scores were higher in the adequate nutrition group (73.33 ± 5.11) compared with the poor nutrition group (71.57 ± 5.66), with a near-significant trend (p=0.095).

Conclusion: Nutritional adequacy postoperatively showed consistent favorable trends towards recovery and 3-month QOL post cardiac valve replacement surgery, while the lack of statistically significant difference in early postoperative CRP levels between adequate and poor nutrition groups was noted.