Abstract 14773: Progressive Malnutrition During Hospitalization Provides the Additional Long-Term Prognostic Information in Patients Admitted With Acute Decompensated Heart Failure
Backgrounds: Malnutrition is associated with increased mortality risk in patients (pts) with heart failure. Nutritional status tends to worsen during hospitalization for acute decompensated heart failure (ADHF). However, there is no information available on the long-term prognostic significance of the progression of malnutrition during the hospitalization in pts admitted with ADHF.
Methods and Results: We studied 305 consecutive pts admitted with ADHF and discharged with survival. Nutritional status was evaluated on admission and at discharge, by Geriatric nutritional risk index (GNRI) calculated as follows: 14.89 x serum albumin (g/dl) + 41.7 x body mass index/22. These pts were classified into 2 groups according to GNRI on admission: low (< 92) GNRI (n=110) with moderate or severe nutritional risk; and high (≥ 92) GNRI (n=195) with no or low nutritional risk. Pts in the low-GNRI group were older, and had lower serum Hb, sodium and GFR but higher serum BUN, compared to those in the high-GNRI group (p<0.05, respectively). GNRI significantly decreased from admission to discharge (96.7±10.8 to 94.1±10.3, p<0.0001). During a follow-up period of 4.4±3.3 yrs, 69 pts had cardiovascular death (CVD). At multivariate Cox analysis, GNRI on admission (p=0.004) and the GNRI change from admission to discharge (p=0.0003) were significantly associated with CVD, independently of age, serum sodium, BUN and GFR. In the low-GNRI group, CVD was significantly frequently observed in pts with than without the progressive malnutrition, which was defined as the GNRI change from admission to discharge with the lowest tertile (52% vs 30%, p=0.02, adjusted HR: 2.6 (95%CI 1.2-5.4)). Furthermore, in the high-GNRI group, the progressive malnutrition also had significantly higher risk of CVD (23% vs 10%, p=0.02, adjusted HR: 2.3 (95%CI 1.1-4.9)).
Conclusion: Progressive malnutrition during hospitalization could provide the additional long-term prognostic information in ADHF pts.
- © 2013 by American Heart Association, Inc.