Nutritional Risk and Mortality at One Year for Elderly Patients Hospitalized with Nonvalvular Atrial Fibrillation. NONAVASC Registry
Por:
Miquelez, A, Calleja, M, Gullon, A, Reino, A, Formiga, F, Camafort, M, Rodrigo, J, Mostaza, J, Fernandez, C, Diez-Manglano, J and Spanish Soc Internal Med
Publicada:
1 sep 2020
Ahead of Print:
1 jun 2020
Resumen:
Objectives To determine whether nutritional risk is associated with the mortality of elderly patients hospitalized with nonvalvular atrial fibrillation (NVAF). Design Prospective, multicenter cohort study. Setting Internal medicine departments in Spain. Participants Inpatients >75 years with NVAF. Measurements We measured the thrombotic and hemorrhagic risk at admission using the CHA2DS2-VASc and HAS-BLED scales, respectively, and the nutritional risk with the controlling nutritional status (CONUT) index. We established 4 degrees of nutritional risk: null (CONUT score 0-1 point), low (2-4 points), moderate (5-8 points) and high (9-12 points). We also conducted a 1-year follow-up. Results We included 449 patients, with a mean age of 85.2(5.2) years. The nutritional risk was null for 70(15.6%) patients, low for 206 45.9%), moderate for 152(33.8%) and high for 21(4.7%). At the end of one year, 177(39.4%) patients had died. The score on the CONUT index was higher for the deceased patients (4.6 vs. 3.6, p<0.001). The CONUT score (HR, 1.076; 95%CI 1.009-1.148; p=0.025), the Charlson index (HR, 1.080; 95%CI 1.017-1.148; p=0.013) and the presence of pressure ulcers (HR, 1.700; 95%CI 1.028-2.810; p=0.039) were independently associated with increased mortality at one year of follow-up. The prescription of oral anticoagulants at discharge was associated with lower mortality (HR, 0.440; 95%CI 0.304-0.638; p<0.001). Conclusions More than a third of elderly patients hospitalized with NVAF have a moderate to high nutritional risk. These patients have greater mortality at the end of one year.
Filiaciones:
Miquelez, A:
Univ Hosp Miguel Servet, Dept Internal Med, Zaragoza, Spain
Calleja, M:
Univ Hosp Miguel Servet, Dept Internal Med, Zaragoza, Spain
Gullon, A:
Univ Hosp La Princesa, Dept Internal Med, Madrid, Spain
Reino, A:
Univ Hosp Complex Santiago de Compostela, Dept Internal Med, Santiago, Spain
Formiga, F:
Univ Hosp Bellvitge Hospitalet de Llobregat, Dept Internal Med, Lhospitalet De Llobregat, Spain
Camafort, M:
Hosp Clin Barcelona, Dept Internal Med, Barcelona, Spain
:
Hosp Vega Baja, Dept Internal Med, Orihuela, Spain
Mostaza, J:
Hosp Carlos III Madrid, Dept Internal Med, Madrid, Spain
Fernandez, C:
Univ Hosp La Princesa, Dept Internal Med, Madrid, Spain
Diez-Manglano, J:
Hosp Royo Villanova, Dept Internal Med, Zaragoza, Spain
Univ Hosp Miguel Servet, Dept Imernal Med, Zaragoza, Spain
Univ Hosp La Princess, Dept Internal Med, Madrid, Spain
Univ Hosp Complex Santiago de Compostela, Dept Internal Med, Santiago De Compostela, Spain
Univ Hosp Bellvitge, Dept Internal Med, Lhospitalet De Llobregat, Spain
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