Nutritional status is related to heart failure severity and hospital readmissions in acute heart failure

Int J Cardiol. 2017 Mar 1:230:108-114. doi: 10.1016/j.ijcard.2016.12.067. Epub 2016 Dec 19.

Abstract

Background: Malnutrition is common in hospitalized heart failure (HF) patients and predicts adverse outcomes. The relationship between nutritional status and outcomes in HF has been partially studied. Our aim was to determine the relationship between the nutritional status and the long-term prognosis in patients hospitalized for acute HF.

Methods: We analyzed 145 patients admitted consecutively to a cardiology department for acute HF. Nutritional status was measured with the CONUT method, a validated scale based on laboratory testing (albumin; cholesterol; lymphocytes) during hospitalization. Patients were classified as normal, mildly, moderately or severely malnourished, and followed in a HF clinic.

Results: The mean aged of the population was 69.6years and 61% of patients were men, 54 had previous HF hospitalization (37%), 112 had hypertension (77%), 67 were diabetic (46%) and 135 had class III or IV NYHA (93%). Forty eight patients (33%) had normal nutritional status, 75 were mildly malnourished (52%), and 22 were moderately or severely malnourished (15%). Age, sex, hypertension, diabetes mellitus, or NYHA class among the three groups were not statistically different. ProBNP was directly correlated with the nutritional status. After a mean follow-up of 326days, 27 had a HF hospitalization (19%) and 61 (42,1%) had a hospitalization not related to HF. The analysis by Kaplan-Meier curves and log rank test showed that these differences were statistically significant.

Conclusion: Malnutrition is common in patients hospitalized for HF. It seems to be a mediator of disease progression and determines a poor prognosis especially in advanced stages.

Keywords: CONUT; Heart failure; Malnutrition; Readmission.

Publication types

  • Observational Study

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Female
  • Heart Failure / complications*
  • Heart Failure / mortality*
  • Heart Failure / therapy
  • Humans
  • Male
  • Malnutrition / diagnosis*
  • Malnutrition / etiology
  • Malnutrition / mortality
  • Middle Aged
  • Nutritional Status*
  • Patient Readmission*
  • Prognosis
  • Retrospective Studies
  • Risk Factors