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. 2021 May 14;13(5):1669.
doi: 10.3390/nu13051669.

The Association between Nutritional Status and In-Hospital Mortality among Patients with Heart Failure-A Result of the Retrospective Nutritional Status Heart Study 2 (NSHS2)

Michał Czapla  1   2 , Raúl Juárez-Vela  3 , Katarzyna Łokieć  4 , Piotr Karniej  1
Affiliations

The Association between Nutritional Status and In-Hospital Mortality among Patients with Heart Failure-A Result of the Retrospective Nutritional Status Heart Study 2 (NSHS2)

Michał Czapla et al. Nutrients. .

Abstract

Background: A nutritional status is related to the prognosis and length of hospitalisation of patients with heart failure (HF). This study aims to assess the effect of nutritional status on in-hospital mortality in patients with heart failure.

Methods: We conducted a retrospective study and analysis of medical records of 1056 patients admitted to the cardiology department of the University Clinical Hospital in Wroclaw (Poland).

Results: A total of 1056 individuals were included in the analysis. A total of 5.5% of patients died during an in-hospital stay. It was found that in the sample group, 25% of patients who died had a BMI (body mass index) within the normal range, 6% were underweight, 47% were overweight, and 22% were obese. Our results show that non-survivors have a significantly higher nutrition risk screening (NRS) ≥3 (21% vs. 3%; p < 0.001); NYHA (New York Heart Association) grade 4 (70% vs. 24%; p < 0.001). The risk of death was lower in obese patients (HR = 0.51; p = 0.028) and those with LDL (low-density lipoprotein) levels from 116 to <190 mg/dL (HR = 0.10; p = 0.009, compared to those with LDL <55 mg/dL). The risk of death was higher in those with NRS (nutritional risk score) score ≥3 (HR = 2.31; p = 0.014), HFmrEF fraction (HR = 4.69; p < 0.001), and LDL levels > 190 mg/dL (HR = 3.20; p = 0.038).

Conclusion: The malnutrition status correlates with an increased risk of death during hospitalisation. Higher TC (total cholesterol) level were related to a lower risk of death, which may indicate the "lipid paradox". Higher BMI results were related to a lower risk of death, which may indicate the "obesity paradox".

Keywords: NRS2002; heart failure; lipid paradox; malnutrition; nutritional status; obesity paradox.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The analysis of survival of the whole group.
Figure 2
Figure 2
The comparison of survival curves according to BMI results. Abbreviations: BMI, body mass index.
Figure 3
Figure 3
The comparison of survival curves according to NRS scores. Abbreviations: NRS, nutritional risk screening.
Figure 4
Figure 4
The comparison of survival curves according to LDL scores. Abbreviations: LDL, low-density lipoprotein.
See this image and copyright information in PMC

References

    1. Roth G.A., Johnson C., Abajobir A., Abd-Allah F., Abera S.F., Abyu G., Ahmed M., Aksut B., Alam T., Alam K., et al. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. J. Am. Coll. Cardiol. 2017;70:1–25. doi: 10.1016/j.jacc.2017.04.052. - DOI - PMC - PubMed
    1. Liu K., Daviglus M.L., Loria C.M., Colangelo L.A., Spring B., Moller A.C., Lloyd-Jones D.M. Healthy Lifestyle Through Young Adulthood and the Presence of Low Cardiovascular Disease Risk Profile in Middle Age. Circulation. 2012;125:996–1004. doi: 10.1161/CIRCULATIONAHA.111.060681. - DOI - PMC - PubMed
    1. Gerber Y., Weston S.A., Redfield M.M., Chamberlain A.M., Manemann S.M., Jiang R., Killian J.M., Roger V.L. A Contemporary Appraisal of the Heart Failure Epidemic in Olmsted County, Minnesota, 2000 to 2010. JAMA Intern. Med. 2015;175:996–1004. doi: 10.1001/jamainternmed.2015.0924. - DOI - PMC - PubMed
    1. Ponikowski P., Voors A.A., Anker S.D., Bueno H., Cleland J.G.F., Coats A.J.S., Falk V., González-Juanatey J.R., Harjola V.-P., Jankowska E.A., et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur. Hear. J. 2016;37:2129–2200. doi: 10.1093/eurheartj/ehw128. - DOI
    1. Aggarwal M., Bozkurt B., Panjrath G., Aggarwal B., Ostfeld R.J., Barnard N.D., Gaggin H., Freeman A.M., Allen K., Madan S., et al. Lifestyle Modifications for Preventing and Treating Heart Failure. J. Am. Coll. Cardiol. 2018;72:2391–2405. doi: 10.1016/j.jacc.2018.08.2160. - DOI - PubMed

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