[Triggers of insufficient calorie intake in hospitalized patients with heart failure and their associations with heart failure rehospitalization and cardiovascular death].

Abstract

Objective: To explore the causes of inadequate caloric intake for hospitalized patients with heart failure and its association with heart failure rehospitalization and cardiovascular death. Methods: This was an observational study. Patients hospitalized for heart failure in Beijing Anzhen Hospital, Capital Medical University from January 2022 to April 2023 were enrolled. Dietary intake for 3 consecutive days during hospitalization was collected. Patients were divided according to the ratio of the mean actual calorie intake to the theoretical calorie requirement: the insufficient calorie intake group (ratio<0.7) and the sufficient calorie intake group (ratio≥0.7). Baseline clinical characteristics, calorie and nutrient intake, as well as the incidence of heart failure rehospitalization and cardiovascular death within 6 months after discharge were collected and compared between the two groups. Logistic regression models were used to analyze the association between calorie intake and the risk of heart failure rehospitalization and cardiovascular death. Results: A total of 261 patients with heart failure were enrolled, with an age of 59 (48, 67) years, including 196 males (75.1%). There were 136 patients in the insufficient calorie intake group and 125 in the sufficient calorie intake group. Compared with the sufficient calorie intake group, the insufficient calorie intake group had higher proportions of male patients (116 cases (85.3%) vs. 80 cases (64.0%)), patients with no fixed income (83 cases (61.0%) vs. 24 cases (19.2%)), and higher CONUT scores (3 (2, 4) points vs. 1 (1, 3) points) (all P<0.05). Follow-up results showed that the incidence of the composite endpoint of heart failure rehospitalization and cardiovascular death was higher in the insufficient calorie intake group than in the sufficient calorie intake group (26 cases (20.6%) vs. 12 cases (9.8%), P=0.017). Multivariate logistic regression analysis showed that insufficient calorie intake was a risk factor for heart failure rehospitalization and cardiovascular death within 6 months after discharge (OR=2.450, 95%CI 1.164-5.158, P=0.018). Conclusions: Male patients and those with no fixed income are more prone to insufficient calorie intake, which is accompanied by poorer nutritional status and higher CONUT scores. Furthermore, insufficient calorie intake is a risk factor for rehospitalization and cardiovascular death in patients with heart failure.