Effect of risk of malnutrition on 30-day mortality among older patients with acute heart failure in Emergency Departments.

Acute Disease Aged Aged, 80 and over Emergency Service, Hospital / statistics & numerical data Female Heart Failure / mortality Humans Logistic Models Male Malnutrition / diagnosis Nutrition Assessment Prospective Studies Registries Risk Assessment Risk Factors Spain / epidemiology

Elderly Emergency department Frailty Heart failure Malnutrition Older

Journal

European journal of internal medicine

ISSN: 1879-0828

Titre abrégé: Eur J Intern Med

Pays: Netherlands

ID NLM: 9003220

Informations de publication

Date de publication:
Jul 2019

Historique:

received: 26 01 2019

revised: 19 03 2019

accepted: 23 04 2019

pubmed: 12 5 2019

medline: 17 9 2020

entrez: 12 5 2019

Statut: ppublish

Résumé

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. 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. 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. 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.

Sections du résumé

BACKGROUND BACKGROUND

MATERIAL AND METHODS 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 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 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.

Identifiants

DOI: 10.1016/j.ejim.2019.04.014 PMID: 31076345

pubmed: 31076345

pii: S0953-6205(19)30120-7

doi: 10.1016/j.ejim.2019.04.014

pii:

doi:

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

Pagination

69-77