PMID- 33236050
OWN - NLM
STAT- MEDLINE
DCOM- 20210319
LR  - 20230214
IS  - 1938-3207 (Electronic)
IS  - 0002-9165 (Linking)
VI  - 113
IP  - 3
DP  - 2021 Mar 11
TI  - The impact of malnutrition on short-term morbidity and mortality in ambulatory 
      patients with heart failure.
PG  - 695-705
LID - 10.1093/ajcn/nqaa311 [doi]
AB  - BACKGROUND: Malnutrition is common in patients with chronic heart failure (CHF) 
      and is associated with adverse outcomes, but it is uncertain how malnutrition 
      should best be evaluated. OBJECTIVES: This prospective cohort study aims to 
      compare the short-term prognostic value of 9 commonly used malnutrition tools in 
      patients with CHF. METHODS: We assessed, simultaneously, 3 simple tools 
      [Controlling Nutritional Status (CONUT) score, Geriatric Nutritional Risk Index, 
      and Prognostic Nutritional Index], 3 multidimensional tools [Malnutrition 
      Universal Screening Tool, Mini Nutritional Assessment-Short Form (MNA-SF), 
      Subjective Global Assessment], and 3 laboratory tests (serum cholesterol, 
      albumin, and total lymphocyte count) in consecutive patients with CHF attending a 
      routine follow-up. The primary end point was all-cause mortality; the secondary 
      end point was the combination of all-cause hospitalization and all-cause 
      mortality. RESULTS: In total, 467 patients [67% male, median age 76 y (range: 
      21-98 y), median N-terminal pro-B-type natriuretic peptide (NT-proBNP) 1156 ng/L] 
      were enrolled. During a median follow-up of 554 d, 82 (18%) patients died and 201 
      (43%) patients either had a nonelective hospitalization or died. In models 
      corrected for age, hemoglobin (Hb), renal function, New York Heart Association 
      (NYHA) class, NTproBNP, BMI, and comorbidities, all malnutrition tools, except 
      total lymphocyte count and serum cholesterol, were independently associated with 
      worse morbidity and mortality. A base model for predicting mortality, including 
      age, NYHA class, log [NT-proBNP], Hb, renal function, and comorbidities, had a 
      C-statistic of 0.757. CONUT (C-statistic = 0.777), among simple tools; MNA-SF 
      (C-statistic = 0.776), among multidimensional tools; and albumin 
      (C-statistic = 0.773), among biochemical tests, increased model performance most 
      compared with the base model. Patients with serum albumin <30 g/L had a 6-fold 
      increase in mortality compared with patients with albumin >/=35 g/L. CONCLUSIONS: 
      Malnutrition is strongly associated with adverse outcomes in patients with CHF. 
      Measuring serum albumin provides comparable prognostic information to simple or 
      multidimensional malnutrition tools.
CI  - (c) The Author(s) 2020. Published by Oxford University Press on behalf of the 
      American Society for Nutrition.
FAU - Sze, Shirley
AU  - Sze S
AD  - Department of Cardiology, Castle Hill Hospital, Hull York Medical School, 
      University of Hull, Hull, UK.
AD  - NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, 
      UK.
FAU - Pellicori, Pierpaolo
AU  - Pellicori P
AD  - Department of Cardiology, Castle Hill Hospital, Hull York Medical School, 
      University of Hull, Hull, UK.
AD  - Robertson Centre for Biostatistics & Clinical Trials, University of Glasgow, 
      Glasgow, UK.
FAU - Zhang, Jufen
AU  - Zhang J
AD  - Department of Cardiology, Castle Hill Hospital, Hull York Medical School, 
      University of Hull, Hull, UK.
AD  - School of Medicine, Anglia Ruskin University, Cambridge, UK.
FAU - Weston, Joan
AU  - Weston J
AD  - Department of Cardiology, Castle Hill Hospital, Hull York Medical School, 
      University of Hull, Hull, UK.
FAU - Clark, Andrew L
AU  - Clark AL
AD  - Department of Cardiology, Castle Hill Hospital, Hull York Medical School, 
      University of Hull, Hull, UK.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Clin Nutr
JT  - The American journal of clinical nutrition
JID - 0376027
SB  - IM
CIN - Am J Clin Nutr. 2021 Mar 11;113(3):501-502. PMID: 33515012
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Heart Failure/*mortality/*pathology
MH  - Humans
MH  - Male
MH  - Malnutrition/*pathology
MH  - Middle Aged
MH  - Risk Factors
MH  - Young Adult
OTO - NOTNLM
OT  - heart failure
OT  - hospitalization
OT  - malnutrition
OT  - mortality
OT  - prognosis
EDAT- 2020/11/26 06:00
MHDA- 2021/03/20 06:00
CRDT- 2020/11/25 05:47
PHST- 2020/04/23 00:00 [received]
PHST- 2020/10/07 00:00 [accepted]
PHST- 2020/11/26 06:00 [pubmed]
PHST- 2021/03/20 06:00 [medline]
PHST- 2020/11/25 05:47 [entrez]
AID - S0002-9165(22)00633-5 [pii]
AID - 10.1093/ajcn/nqaa311 [doi]
PST - ppublish
SO  - Am J Clin Nutr. 2021 Mar 11;113(3):695-705. doi: 10.1093/ajcn/nqaa311.