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.
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