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Journal of Parenteral and Enteral Nutrition
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Diagnosis-Related Group Impact of Nutrition Support in Cardiac Surgery Patients

Louis Flancbaum, M.D.

UMDNJ-Robert Wood Johnson Medical School, Department of Surgery, New Brunswick, New Jersey

Robert E. Brolin, M.D.

UMDNJ-Robert Wood Johnson Medical School, Department of Surgery, New Brunswick, New Jersey

Maria Kirzecky, R.PH., M.B.A.

UMDNJ-Robert Wood Johnson Medical School, Department of Surgery, New Brunswick, New Jersey

Bruce A. Mast, M.D.

UMDNJ-Robert Wood Johnson Medical School, Department of Surgery, New Brunswick, New Jersey

Ciel E. Smith, B.S., R.D.

UMDNJ-Robert Wood Johnson Medical School, Department of Surgery, New Brunswick, New Jersey

Hallis A. Kenler, PH.D.

UMDNJ-Robert Wood Johnson Medical School, Department of Surgery, New Brunswick, New Jersey

Ellen M. Wallis, M.B.A.

UMDNJ-Robert Wood Johnson Medical School, Department of Surgery, New Brunswick, New Jersey

James W. Mackenzie, M.D.

UMDNJ-Robert Wood Johnson Medical School, Department of Surgery, New Brunswick, New Jersey

We studied the diagnosis-related groups (DRG) impact of nutrition support on 80 consecutive cardiac surgery patients operated upon during a 6-month period. Six of 80 patients were nutritionally depleted preoperatively. Seven received postoperative supplemental nutrition, all of whom had major postoperative complications. Patients were arbitrarily placed into three outcome groups: group I consisted of seven patients who received postoperative nutrition support; group II included 38 patients who received no nutrition support and did not develop complications; Group III consisted of 35 patients who received no nutrition support but developed postoperative complications. All group I patients were length of stay (LOS) outliers. Group I patients were significantly older than groups II and III (p < 0.0003) and had a significantly longer average length of stay (ALOS) (p < 0.001), ALOS in SICU (p < 0.0001) and greater incidence of both septic complications (p < 0.02) and mortality (p < 0.02). Nutrition support in cardiac surgery patients warrants special DRG consideration in light of the significantly increased hospitalization and resource utilization as compared with all other patients in cardiac surgery. (Journal of Parenteral and Enteral Nutrition 12:473-477, 1988)

Journal of Parenteral and Enteral Nutrition, Vol. 12, No. 5, 473-477 (1988)
DOI: 10.1177/0148607188012005473
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