Predictive value of triglycerides-total cholesterol-body weight index for prolonged postoperative length of stay in patients undergoing coronary artery bypass grafting_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LU Meiying ¹ , SHEN Xingran ¹ , HUANG Miaomiao ¹ , ZHANG Wen ³ , GENG Li ³ , XIONG Chang’e ² ,  ZHANG Yinghong ¹

1. School of Medicine, Wuhan University of Science and Technology, Wuhan, 430065, P. R. China;
2. School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, P. R. China;
3. Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan University of Science and Technology, Wuhan, 430022, P. R. China;

Corresponding author：

ZHANG Yinghong, Email: zhangyinghong@wust.edu.cn

Keywords：

Coronary artery bypass grafting; prolonged postoperative hospital stay; triglyceride-total cholesterol-body weight index; nutritional index

DOI：

10.7507/1007-4848.202506026

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the predictive value of a new nutritional index, triglycerides-total cholesterol-body mass index (TCBI), for prolonged postoperative hospital stay in patients undergoing coronary artery bypass grafting surgery (CABG). Methods A retrospective analysis was conducted on the clinical data of CABG patients admitted to Wuhan Asian Heart Hospital, Wuhan University of Science and Technology from January 2022 to March 2024. Based on the postoperative hospital stay duration of CABG patients, they were divided into two groups: normal hospital stay group (≤14 days) and prolonged hospital stay group (>14 days). Univariate and multivariate logistic regression analyses were used to identify independent factors associated with prolonged postoperative hospital stay in CABG patients. The receiver operating characteristic (ROC) curve was employed to evaluate the predictive value of TCBI for prolonged postoperative hospital stay. Results A total of 460 patients were included, with 289 males (62.8%) and 171 females (37.2%), with an average age of 67 years (range 35-83 years). The TCBI level in the prolonged hospital stay group was significantly lower than that in the normal hospital stay group [1161.71 (825.36, 1511.78) vs. 1777.60 (1354.53, 2448.60), P<0.001]. Multivariate logistic regression analysis revealed that drinking history (OR=2.222, P=0.022), low absolute lymphocyte count (OR=0.169, P<0.001), low serum albumin (OR=0.624, P<0.001), and low TCBI (OR=0.816, P<0.001) were independent risk factors for prolonged postoperative hospital stay in CABG patients. ROC curve results showed that the area under the curve for TCBI to predict prolonged hospital stay was 0.808, with a sensitivity of 72.8% and specificity of 70.9% at a cutoff value of 1446.11. Conclusion TCBI is an effective predictive indicator for prolonged postoperative hospital stay in CABG patients, and the risk of prolonged postoperative hospital stay is higher in CABG patients with TCBI ≤1446.11.

1.	Li Y, Zhong W, Liu Z, et al. Aldehyde dehydrogenase 2 rs671 G/A and a/A genotypes are associated with the risk of acute myocardial infarction. Int J Gen Med, 2024, 17: 3591-3600.
2.	Liu TD, Zheng YY, Tang JN, et al. Prognostic nutritional index as a novel predictor of long-term prognosis in patients with coronary artery disease after percutaneous coronary intervention. Clin Appl Thromb Hemost, 2022, 28: 10760296221103271.
3.	Coskun C, Borulu F, Emir I, et al. Investigation of the relationship between cerebral near-infrared spectroscopy measurements and cerebrovascular event in coronary artery bypass grafting operation in patients without carotid stenosis and patients with carotid stenosis below surgical margins. Braz J Cardiovasc Surg, 2020, 35(4): 465-470.
4.	Kim H, Bae SH, Lim SH, et al. Predictors of health-related quality of life after coronary artery bypass graft surgery. Sci Rep, 2022, 12(1): 16119.
5.	Liu Y, Song C, Wang X, et al. Prevalence of malnutrition among adult inpatients in China: a nationwide cross-sectional study. Sci China Life Sci, 2025, 68(5): 1487-1497.
6.	Wang B, Guo Z, Liu J, et al. Mild malnutrition contributes the greatest to the poor prognosis in coronary artery disease with well-controlled low-density lipoprotein cholesterol levels: a 4, 863 Chinese cohort study. Front Nutr, 2021, 8: 725537.
7.	Wong A, Huang Y, Banks MD, et al. A cost-consequence analysis of nutritional interventions used in hospital settings for older adults with or at risk of malnutrition. Healthcare, 2024, 12(10): 1041.
8.	彭盼, 张迎红, 周莉, 等. 心血管疾病患者营养评估工具的研究进展. 中国实用护理杂志, 2024, 40(21): 1671-1675.Peng P, Zhang YH, Zhou L, et al. Research progress of nutritional assessment tools in patients with cardiovascular diseases. Chin J Pract Nurs, 2024, 40(21): 1671-1675.
9.	Ding H, Li C, Zhao X. The relationship between intrinsic capacity and sarcopenia in middle-aged and older Chinese populations: the mediating influence of a novel nutritional index. Front Public Health, 2025, 13: 1605158.
10.	Maruyama S, Ebisawa S, Miura T, et al. Impact of nutritional index on long-term outcomes of elderly patients with coronary artery disease: sub-analysis of the SHINANO 5 year registry. Heart Vessels, 2021, 36(1): 7-13.
11.	Wang C, Qing Y, Chen W, et al. A novel nutritional index as a predictor of mortality in dilated cardiomyopathy: a retrospective study. PeerJ, 2022, 10: e12704.
12.	Liu Q, Zhang J. Assessment and prediction of the nutritional index in septic patients: a propensity score-matched analysis. Res Square, 2023.
13.	Sudo M, Shamekhi J, Aksoy A, et al. A simply calculated nutritional index provides clinical implications in patients undergoing transcatheter aortic valve replacement. Clin Res Cardiol, 2024, 113(1): 58-67.
14.	Fan X, He Q, Zhang K, et al. Comparison of the value of four objective nutritional indices in assessing the long-term prognosis of elderly patients with heart failure with preserved ejection fraction. Rev Cardiovasc Med, 2024, 25(6): 201.
15.	Wen Z, Wang Y, Chen S, et al. Construction of a predictive model for postoperative hospitalization time in colorectal cancer patients based on interpretable machine learning algorithm: a prospective preliminary study. Front Oncol, 2024, 14: 1384931.
16.	Saravi B, Zink A, Ülkümen S, et al. Performance of artificial intelligence-based algorithms to predict prolonged length of stay after lumbar decompression surgery. J Clin Med, 2022, 11(14): 4050.
17.	Martínez-Pérez A, Payá-Llorente C, Santarrufina-Martínez S, et al. Predictors for prolonged length of stay after laparoscopic appendectomy for complicated acute appendicitis in adults. Surg Endosc, 2021, 35(7): 3628-3635.
18.	中国血脂管理指南修订联合专家委员会. 中国血脂管理指南(基层版2024年). 中华心血管病杂志, 2024, 52(4): 330-337.Joint Expert Committee on Revision of Chinese Lipid Management Guidelines. Chinese guideline for lipid management (primary care version 2024). Chin J Cardiol, 2024, 52(4): 330-337.
19.	任旭博, 张义沛, 井晶, 等. 新型营养指数与冠状动脉病变程度相关性研究. 临床心血管病杂志, 2023, 39(3): 208-213.Ren XB, Zhang YP, Jing J, et al. Correlation study between new nutritional index (TCBI) and coronary artery disease degree. J Clin Cardiol, 2023, 39(3): 208-213.
20.	Poldrack RA, Huckins G, Varoquaux G. Establishment of best practices for evidence for prediction a review. JAMA Psychiatry, 2020, 77(5): 534-540.
21.	李瑞冰, 郭立新, 郭宇, 等. 营养风险筛查在冠状动脉旁路移植术患者中的应用. 中国临床研究, 2020, 33(3): 384-386,390.Li RB, Guo LX, Guo Y, et al. Nutritional risk screening in patients undergoing coronary artery bypass grafting. Chin J Clin Res, 2020, 33(3): 384-386,390.
22.	Ścisło L, Bizoń A, Walewska E, et al. Nutritional status of elderly patients after coronary artery bypass surgery. Int J Environ Res Public Health, 2019, 16(2): 226.
23.	Ávila NGD, Carneiro JU, Alves FD, et al. Prevalence of malnutrition and its association with clinical complications in hospitalized cardiac patients: retrospective cohort study. Int J Cardiovasc Sci, 2020, 33(6): 629-634.
24.	Keng BM, Gao F, Teo LL, et al. Associations between skeletal muscle and myocardium in ageing: a syndrome of 'cardio-sarcopenia'? J Am Geriatr Soc, 2019, 67(12): 2568-2573.
25.	Ding H, Li C, Zhao X. The relationship between intrinsic capacity and sarcopenia in middle-aged and older Chinese populations: the mediating influence of a novel nutritional index. Front Public Health, 2025, 13: 1605158.
26.	Ren QW, Teng THK, Ouwerkerk W, et al. Triglyceride levels and its association with all-cause mortality and cardiovascular outcomes among patients with heart failure. Nat Commun, 2025, 16(1): 1408.
27.	王滢莹, 秦俭, 程丽芳. 肥胖悖论与心血管疾病. 心血管病学进展, 2022, 43(1): 52-55.Wang YY, Qin J, Cheng LF. Obesity paradox and cardiovascular diseases. Adv Cardiovasc Dis, 2022, 43(1): 52-55.
28.	刘喜平, 窦志飞, 施晓宇. 老年病人继发性低胆固醇血症与感染关系及对预后的影响. 肠外与肠内营养, 2014, 21(2): 98-100,105.Liu XP, Dou ZF, Shi FY. Elderly secondary hypocholesterolemia may relate to infections and influence prognoses. Parenter Enteral Nutr, 2014, 21(2): 98-100,105.
29.	王清, 张娜, 吕星, 等. 血脂异常与类风湿关节炎患者的心血管疾病风险的研究进展. 中华医学杂志, 2022, 102(32): 2559-2562.Wang Q, Zhang N, Lv X, et al. Advances in the study of dyslipidemia and cardiovascular disease risk in patients with rheumatoid arthritis. Natl Med J China, 2022, 102(32): 2559-2562.
30.	文磊. PNI联合TCBI对STEMI患者PCI术后1年内发生MACE的预测价值研究. 扬州大学, 2024.Wen L. Predictive value of PNI combined with TCBI for MACE within one year after PCI in STEMI patients. Yangzhou University, 2024.
31.	Jones NR, Ordóñez-Mena JM, Roalfe AK, et al. Body mass index and survival in people with heart failure. Heart, 2023, 109(20): 1542-1549.
32.	刘赛, 张凯文, 郭金成, 等. 预后营养指数与老年ST段抬高型心肌梗死冠状动脉介入后不良事件风险的研究. 心肺血管病杂志, 2025, 44(5): 443-449,532.Liu S, Zhang KW, Guo JC, et al. Association between prognostic nutritional index and one-year major adverse cardiovascular events in elderly patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. J Cardiovasc Pulm Dis, 2025, 44(5): 443-449,532.
33.	Juliana N, Abd Aziz NAS, Maluin SM, et al. Nutritional status and post-cardiac surgery outcomes: an updated review with emphasis on cognitive function. J Clin Med, 2024, 13(14): 4015.
34.	宋习文. 早期他汀类药物治疗对入院心功能KillipⅢ/Ⅳ级急性冠脉综合征患者院内预后的影响. 天津医科大学, 2022.Song XW. Effect of early statin therapy on in-hospital prognosis of acute coronary syndrome patients presenting with Killip Ⅲ/Ⅳ at admission. Tianjin: Tianjin Medical University, 2022.

1. Li Y, Zhong W, Liu Z, et al. Aldehyde dehydrogenase 2 rs671 G/A and a/A genotypes are associated with the risk of acute myocardial infarction. Int J Gen Med, 2024, 17: 3591-3600.
2. Liu TD, Zheng YY, Tang JN, et al. Prognostic nutritional index as a novel predictor of long-term prognosis in patients with coronary artery disease after percutaneous coronary intervention. Clin Appl Thromb Hemost, 2022, 28: 10760296221103271.
3. Coskun C, Borulu F, Emir I, et al. Investigation of the relationship between cerebral near-infrared spectroscopy measurements and cerebrovascular event in coronary artery bypass grafting operation in patients without carotid stenosis and patients with carotid stenosis below surgical margins. Braz J Cardiovasc Surg, 2020, 35(4): 465-470.
4. Kim H, Bae SH, Lim SH, et al. Predictors of health-related quality of life after coronary artery bypass graft surgery. Sci Rep, 2022, 12(1): 16119.
5. Liu Y, Song C, Wang X, et al. Prevalence of malnutrition among adult inpatients in China: a nationwide cross-sectional study. Sci China Life Sci, 2025, 68(5): 1487-1497.
6. Wang B, Guo Z, Liu J, et al. Mild malnutrition contributes the greatest to the poor prognosis in coronary artery disease with well-controlled low-density lipoprotein cholesterol levels: a 4, 863 Chinese cohort study. Front Nutr, 2021, 8: 725537.
7. Wong A, Huang Y, Banks MD, et al. A cost-consequence analysis of nutritional interventions used in hospital settings for older adults with or at risk of malnutrition. Healthcare, 2024, 12(10): 1041.
8. 彭盼, 张迎红, 周莉, 等. 心血管疾病患者营养评估工具的研究进展. 中国实用护理杂志, 2024, 40(21): 1671-1675.Peng P, Zhang YH, Zhou L, et al. Research progress of nutritional assessment tools in patients with cardiovascular diseases. Chin J Pract Nurs, 2024, 40(21): 1671-1675.
9. Ding H, Li C, Zhao X. The relationship between intrinsic capacity and sarcopenia in middle-aged and older Chinese populations: the mediating influence of a novel nutritional index. Front Public Health, 2025, 13: 1605158.
10. Maruyama S, Ebisawa S, Miura T, et al. Impact of nutritional index on long-term outcomes of elderly patients with coronary artery disease: sub-analysis of the SHINANO 5 year registry. Heart Vessels, 2021, 36(1): 7-13.
11. Wang C, Qing Y, Chen W, et al. A novel nutritional index as a predictor of mortality in dilated cardiomyopathy: a retrospective study. PeerJ, 2022, 10: e12704.
12. Liu Q, Zhang J. Assessment and prediction of the nutritional index in septic patients: a propensity score-matched analysis. Res Square, 2023.
13. Sudo M, Shamekhi J, Aksoy A, et al. A simply calculated nutritional index provides clinical implications in patients undergoing transcatheter aortic valve replacement. Clin Res Cardiol, 2024, 113(1): 58-67.
14. Fan X, He Q, Zhang K, et al. Comparison of the value of four objective nutritional indices in assessing the long-term prognosis of elderly patients with heart failure with preserved ejection fraction. Rev Cardiovasc Med, 2024, 25(6): 201.
15. Wen Z, Wang Y, Chen S, et al. Construction of a predictive model for postoperative hospitalization time in colorectal cancer patients based on interpretable machine learning algorithm: a prospective preliminary study. Front Oncol, 2024, 14: 1384931.
16. Saravi B, Zink A, Ülkümen S, et al. Performance of artificial intelligence-based algorithms to predict prolonged length of stay after lumbar decompression surgery. J Clin Med, 2022, 11(14): 4050.
17. Martínez-Pérez A, Payá-Llorente C, Santarrufina-Martínez S, et al. Predictors for prolonged length of stay after laparoscopic appendectomy for complicated acute appendicitis in adults. Surg Endosc, 2021, 35(7): 3628-3635.
18. 中国血脂管理指南修订联合专家委员会. 中国血脂管理指南(基层版2024年). 中华心血管病杂志, 2024, 52(4): 330-337.Joint Expert Committee on Revision of Chinese Lipid Management Guidelines. Chinese guideline for lipid management (primary care version 2024). Chin J Cardiol, 2024, 52(4): 330-337.
19. 任旭博, 张义沛, 井晶, 等. 新型营养指数与冠状动脉病变程度相关性研究. 临床心血管病杂志, 2023, 39(3): 208-213.Ren XB, Zhang YP, Jing J, et al. Correlation study between new nutritional index (TCBI) and coronary artery disease degree. J Clin Cardiol, 2023, 39(3): 208-213.
20. Poldrack RA, Huckins G, Varoquaux G. Establishment of best practices for evidence for prediction a review. JAMA Psychiatry, 2020, 77(5): 534-540.
21. 李瑞冰, 郭立新, 郭宇, 等. 营养风险筛查在冠状动脉旁路移植术患者中的应用. 中国临床研究, 2020, 33(3): 384-386,390.Li RB, Guo LX, Guo Y, et al. Nutritional risk screening in patients undergoing coronary artery bypass grafting. Chin J Clin Res, 2020, 33(3): 384-386,390.
22. Ścisło L, Bizoń A, Walewska E, et al. Nutritional status of elderly patients after coronary artery bypass surgery. Int J Environ Res Public Health, 2019, 16(2): 226.
23. Ávila NGD, Carneiro JU, Alves FD, et al. Prevalence of malnutrition and its association with clinical complications in hospitalized cardiac patients: retrospective cohort study. Int J Cardiovasc Sci, 2020, 33(6): 629-634.
24. Keng BM, Gao F, Teo LL, et al. Associations between skeletal muscle and myocardium in ageing: a syndrome of 'cardio-sarcopenia'? J Am Geriatr Soc, 2019, 67(12): 2568-2573.
25. Ding H, Li C, Zhao X. The relationship between intrinsic capacity and sarcopenia in middle-aged and older Chinese populations: the mediating influence of a novel nutritional index. Front Public Health, 2025, 13: 1605158.
26. Ren QW, Teng THK, Ouwerkerk W, et al. Triglyceride levels and its association with all-cause mortality and cardiovascular outcomes among patients with heart failure. Nat Commun, 2025, 16(1): 1408.
27. 王滢莹, 秦俭, 程丽芳. 肥胖悖论与心血管疾病. 心血管病学进展, 2022, 43(1): 52-55.Wang YY, Qin J, Cheng LF. Obesity paradox and cardiovascular diseases. Adv Cardiovasc Dis, 2022, 43(1): 52-55.
28. 刘喜平, 窦志飞, 施晓宇. 老年病人继发性低胆固醇血症与感染关系及对预后的影响. 肠外与肠内营养, 2014, 21(2): 98-100,105.Liu XP, Dou ZF, Shi FY. Elderly secondary hypocholesterolemia may relate to infections and influence prognoses. Parenter Enteral Nutr, 2014, 21(2): 98-100,105.
29. 王清, 张娜, 吕星, 等. 血脂异常与类风湿关节炎患者的心血管疾病风险的研究进展. 中华医学杂志, 2022, 102(32): 2559-2562.Wang Q, Zhang N, Lv X, et al. Advances in the study of dyslipidemia and cardiovascular disease risk in patients with rheumatoid arthritis. Natl Med J China, 2022, 102(32): 2559-2562.
30. 文磊. PNI联合TCBI对STEMI患者PCI术后1年内发生MACE的预测价值研究. 扬州大学, 2024.Wen L. Predictive value of PNI combined with TCBI for MACE within one year after PCI in STEMI patients. Yangzhou University, 2024.
31. Jones NR, Ordóñez-Mena JM, Roalfe AK, et al. Body mass index and survival in people with heart failure. Heart, 2023, 109(20): 1542-1549.
32. 刘赛, 张凯文, 郭金成, 等. 预后营养指数与老年ST段抬高型心肌梗死冠状动脉介入后不良事件风险的研究. 心肺血管病杂志, 2025, 44(5): 443-449,532.Liu S, Zhang KW, Guo JC, et al. Association between prognostic nutritional index and one-year major adverse cardiovascular events in elderly patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. J Cardiovasc Pulm Dis, 2025, 44(5): 443-449,532.
33. Juliana N, Abd Aziz NAS, Maluin SM, et al. Nutritional status and post-cardiac surgery outcomes: an updated review with emphasis on cognitive function. J Clin Med, 2024, 13(14): 4015.
34. 宋习文. 早期他汀类药物治疗对入院心功能KillipⅢ/Ⅳ级急性冠脉综合征患者院内预后的影响. 天津医科大学, 2022.Song XW. Effect of early statin therapy on in-hospital prognosis of acute coronary syndrome patients presenting with Killip Ⅲ/Ⅳ at admission. Tianjin: Tianjin Medical University, 2022.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Latest ArticlesPredictive value of triglycerides-total cholesterol-body weight index for prolonged postoperative length of stay in patients undergoing coronary artery bypass grafting

Abstract Full text Figures/Tables Video References Cited by

Format

Content