Effect of risk of malnutrition on 30-day mortality among older patients with acute heart failure in Emergency Departments
Por:
Martín-Sánchez FJ, Cuesta Triana F, Rossello X, Pardo García R, Llopis García G, Caimari F, Vidán MT, Ruiz Artacho P, González Del Castillo J, Llorens P, Herrero P, Jacob J, Gil V, Fernández Pérez C, Gil P, Bueno H, Miró Ò, Matía Martín P, Representing the members of the OAK Register Investigators, Rodríguez Adrada E, Santos MC, Salgado L, Brizzi BN, Docavo ML, Del Mar Suárez-Cadenas M, Xipell C, Sánchez C, Aguiló S, Gaytan JM, Jerez A, Pérez-Durá MJ, Berrocal Gil P, López-Grima ML, Valero A, Aguirre A, Pedragosa MÀ, Piñera P, LázaroAragues P, Sánchez Nicolás JA, Rizzi MA, Herrera Mateo S, Alquezar A, Roset A, Ferrer C, Llopis F, Álvarez Pérez JM, López Diez MP, Richard F, Fernández-Cañadas JM, Carratala J, Javaloyes P, Andueza JA, Sevillano Fernández JA, Romero R, Merlo Loranca M, Álvarez Rodríguez V, Lorca MT, Calderón L, Soy Ferrer E, Manuel Garrido J and Martín Mojarro E
Publicada:
1 jul 2019
Ahead of Print:
7 may 2019
Categoría:
Internal medicine
Resumen:
Background: Little is known about the prevalence and impact of risk of malnutrition on short-term mortality among seniors presenting with acute heart failure (AHF) in emergency setting. The objective was to determine the impact of risk of malnutrition on 30-day mortality risk among older patients who attended in Emergency Departments (EDs) for AHF.
Material and methods: We performed a secondary analysis of the OAK-3 Registry including all consecutive patients >= 65 years attending in 16 Spanish EDs for AHF. Risk of malnutrition was defined by the Mini Nutritional Assessment Short Form (MNA-SF) < 12 points. Unadjusted and adjusted logistic regression models were used to assess the association between risk of malnutrition and 30-day mortality.
Results: We included 749 patients (mean age: 85 (SD 6); 55.8% females). Risk of malnutrition was observed in 594 (79.3%) patients. The rate of 30-day mortality was 8.8%. After adjusting for MEESSI-AHF risk score clinical categories (model 1) and after adding all variables showing a significantly different distribution among groups (model 2), the risk of malnutrition was an independent factor associated with 30-day mortality (adjusted OR by model 1 = 3.4; 95% CI 1.2-9.7; p = .020 and adjusted OR by model 2 = 3.1; 95% CI 1.1-9.0; p = .033) compared to normal nutritional status.
Conclusions: The risk of malnutrition assessed by the MNA-SF is associated with 30-day mortality in older patients with AHF who were attended in EDs. Routine screening of risk of malnutrition may help emergency physicians in decision-making and establishing a care plan.
Filiaciones:
Martín-Sánchez FJ:
Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
Universidad Complutense de Madrid, Madrid, Spain
Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
Cuesta Triana F:
Universidad Complutense de Madrid, Madrid, Spain
Department of Geriatric Medicine, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
Rossello X:
Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
Pardo García R:
Universidad Complutense de Madrid, Madrid, Spain
Llopis García G:
Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
Caimari F:
Department of Endocrinology, University College London, Hospitals NHS Foundation Trust, London, UK
Vidán MT:
Universidad Complutense de Madrid, Madrid, Spain
Department of Geriatric Medicine, Hospital General Universitario Gregorio Marañón, Instituto de Investigación IiSGM, Universidad Complutense de Madrid, Madrid, Spain
Ruiz Artacho P:
Department of Internal Medicine, Clínica Universitaria de Navarra, Madrid, Spain
González Del Castillo J:
Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
Universidad Complutense de Madrid, Madrid, Spain
Llorens P:
Emergency Department-UCE-UHD, Hospital General Universitario de Alicante, Alicante, Spain
Herrero P:
Emergency Department, Hospital Central de Asturias, Oviedo, Asturias, Spain
Jacob J:
Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
Gil V:
Emergency Department, Hospital Clínic, Institut de Recerca Biomédica August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
Fernández Pérez C:
Universidad Complutense de Madrid, Madrid, Spain
Preventive Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
Gil P:
Universidad Complutense de Madrid, Madrid, Spain
Department of Geriatric Medicine, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
Bueno H:
Universidad Complutense de Madrid, Madrid, Spain
Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
Department of Cardiology, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain
Miró Ò:
Emergency Department, Hospital Clínic, Institut de Recerca Biomédica August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
Matía Martín P:
Universidad Complutense de Madrid, Madrid, Spain
Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
Rodríguez Adrada E:
Hospital Clínico San Carlos, Madrid, Spain
Santos MC:
Hospital Clínico San Carlos, Madrid, Spain
Salgado L:
Hospital Clínico San Carlos, Madrid, Spain
Brizzi BN:
Hospital Clínico San Carlos, Madrid, Spain
Docavo ML:
Hospital Clínico San Carlos, Madrid, Spain
Del Mar Suárez-Cadenas M:
Hospital Clínico San Carlos, Madrid, Spain
Xipell C:
Hospital Clinic, Barcelona, Spain
Sánchez C:
Hospital Clinic, Barcelona, Spain
Aguiló S:
Hospital Clinic, Barcelona, Spain
Gaytan JM:
Hospital Clinic, Barcelona, Spain
Jerez A:
Hospital Clinic, Barcelona, Spain
Pérez-Durá MJ:
Hospital La Fe, Valencia, Spain
Berrocal Gil P:
Hospital La Fe, Valencia, Spain
:
Hospital Dr. Peset, Valencia, Spain
:
Hospital Dr. Peset, Valencia, Spain
Aguirre A:
Hospital del Mar, Barcelona, Spain
Pedragosa MÀ:
Hospital del Mar, Barcelona, Spain
Piñera P:
Hospital Reina Sofía, Murcia, Spain
LázaroAragues P:
Hospital Reina Sofía, Murcia, Spain
Sánchez Nicolás JA:
Hospital Reina Sofía, Murcia, Spain
Rizzi MA:
Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
Herrera Mateo S:
Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
Alquezar A:
Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
Roset A:
Hospital Universitari de Bellvitge, Barcelona, Spain
Ferrer C:
Hospital Universitari de Bellvitge, Barcelona, Spain
Llopis F:
Hospital Universitari de Bellvitge, Barcelona, Spain
Álvarez Pérez JM:
Hospital Universitario, Burgos, Spain
López Diez MP:
Hospital Universitario, Burgos, Spain
Richard F:
Hospital Universitario, Burgos, Spain
:
Hospital Universitario General de Alicante, Alicante, Spain
Carratala J:
Hospital Universitario General de Alicante, Alicante, Spain
Javaloyes P:
Hospital Universitario General de Alicante, Alicante, Spain
Andueza JA:
Hospital General Universitario Gregorio Marañón, Madrid, Spain
Sevillano Fernández JA:
Hospital General Universitario Gregorio Marañón, Madrid, Spain
Romero R:
Hospital Getafe, Madrid, Spain
Merlo Loranca M:
Hospital Getafe, Madrid, Spain
Álvarez Rodríguez V:
Hospital Getafe, Madrid, Spain
Lorca MT:
Hospital del Tajo, Madrid, Spain
Calderón L:
Hospital del Tajo, Madrid, Spain
Soy Ferrer E:
Hospital JosepTrueta, Girona, Spain
Manuel Garrido J:
Hospital Vírgen de la Macarena, Sevilla, Spain
Martín Mojarro E:
Hospital Sant Pau i Santa Tecla, Tarragona, Spain
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