Correlation between Nutritional Status and Mortality in Patients with Heart Failure

Q4 Nursing

中华临床营养杂志 Pub Date : 2018-02-28 DOI:10.3760/CMA.J.ISSN.1674-635X.2018.01.006

Xin Gong, Chenying Zhu, P. Yu, Xiaoling Xi, Hao Hu, Jianhong Cao

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Abstract

Objective To investigate the nutritional status of patients with heart failure and its effect on all-cause mortality. Methods A total of 351 patients with chronic heart failure, who were consecutively admitted to the East Hospital of Shanghai from March 2013 to November 2015, were put into the heart failure with reduced left ventricular ejection fraction(HFrEF) group. They were compared to 222 controls who were admitted during the same period for preclinical heart failure. After a median follow-up time of 606 days, 108 patients of the HFrEF group died, compared to 11 of the controls. Logistic regression was used to analyze correlations of all-cause mortality with the patients' body mass index (BMI), serum albumin and other factors. Results Compared to the controls, patients with chronic heart failure had lower BMI[(22.71±3.95)kg/m2vs.(24.23±3.66)kg/m2,t=4.331, P=0.000], total cholesterol[(3.81±0.99)mmol/L vs.(4.03±0.96)mmol/L, t=2.638, P=0.009], albumin[(38.18±5.03)g/L vs.(40.18±6.12)g/L, t=3.874, P=0.000] and prealbumin[(187.67±61.83)mg/L vs.(211.94±65.44)mg/L, t=3.937, P=0.000]. Within the HFrEF group, patients with lower BMI had higher mortality (36.0% vs. 22.4%, P=0.008). Logistic regression suggested BMI, age were independent predictors of all-cause death. Conclusions Patients with chronic heart failure had high incidence of malnutrition, and those with BMI<22 kg/m2 had higher risk of mortality. Serum albumin and BMI not only reflected nutritional status of the patients but had significant implications on prognosis. Key words: HFrEF; Nutritional status; All-cause death

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心力衰竭患者营养状况与死亡率的相关性

目的探讨心力衰竭患者的营养状况及其对全因死亡率的影响。方法将2013年3月至2015年11月连续入住上海东方医院的351例慢性心力衰竭患者分为左心室射血分数降低型心力衰竭（HFrEF）组。他们与同期因临床前心力衰竭入院的222名对照组进行了比较。中位随访时间606天后，HFrEF组108名患者死亡，而对照组为11名。采用Logistic回归分析全因死亡率与患者体重指数（BMI）、血清白蛋白等因素的相关性。结果与对照组相比，慢性心力衰竭患者的BMI[（22.71±3.95）kg/m2 vs.（24.23±3.66）kg/m2，t=4.331，P=0.000]、总胆固醇[（3.81±0.99）mmol/L vs.（4.03±0.96）mmol/L，t=2.638，P=0.009]、白蛋白[（38.18±5.03）g/L vs.（40.18±6.12）g/L，t=3.874，P=0.0000]和前白蛋白[（187.67±61.83）mg/L vs.（211.94±65.44）mg/L，t=在HFrEF组中，BMI较低的患者死亡率较高（36.0%对22.4%，P=0.008）。Logistic回归表明，BMI、年龄是全因死亡的独立预测因素。结论慢性心力衰竭患者营养不良发生率高，BMI＜22kg/m2的患者死亡率高。血清白蛋白和BMI不仅反映了患者的营养状况，而且对预后有重要影响。关键词：HFrEF；营养状况；全因死亡

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来源期刊

中华临床营养杂志 Nursing-Nutrition and Dietetics

CiteScore

0.20

自引率

0.00%

发文量

2282

期刊介绍： The Chinese Journal of Clinical Nutrition was founded in 1993. It is the first professional academic journal (bimonthly) in my country co-sponsored by the Chinese Medical Association and the Chinese Academy of Medical Sciences to disseminate information on clinical nutrition support, nutrient metabolism, the impact of nutrition support on outcomes and "cost-effectiveness", as well as translational medicine and nutrition research. It is also a professional journal of the Chinese Medical Association's Parenteral and Enteral Nutrition Branch. The purpose of the Chinese Journal of Clinical Nutrition is to promote the rapid dissemination of knowledge on nutrient metabolism and the rational application of parenteral and enteral nutrition, focusing on the combination of multidisciplinary and multi-regional field investigations and clinical research. It mainly reports on nutritional risk screening related to the indications of parenteral and enteral nutrition support, "cost-effectiveness" research on nutritional drugs, consensus on clinical nutrition, guidelines, expert reviews, randomized controlled studies, cohort studies, glycoprotein and other nutrient metabolism research, systematic evaluation of clinical research, evidence-based case reports, special reviews, case reports and clinical experience exchanges, etc., and has a special column on new technologies related to the field of clinical nutrition and their clinical applications.