ISSN 2996-8215
International Journal of Cardiology | Vol. 4, No. 2, February 2013 | pp. 9–16
DOI: 10.46882/2013/IJC/000047
Original Research Article
Impact of Malnutrition on Clinical Outcomes in Elderly Patients Hospitalized for Acute Heart Failure
Maria G. Silva¹, Joao P. Santos¹, António F. Ribeiro²
¹Department of Internal Medicine and Cardiology, University Hospital of Coimbra, Coimbra, Portugal
²Division of Cardiovascular Medicine, Santa Maria Hospital, University of Lisbon, Lisbon, Portugal
Abstract:
Malnutrition is highly prevalent in elderly patients with chronic diseases and contributes to progressive cachexia. However, its baseline prevalence and direct impact on survival in acute heart failure (AHF) admissions are often underestimated. This prospective study evaluated the prevalence of malnutrition using the Controlling Nutritional Status (CONUT) score and determined its impact on long-term clinical outcomes in elderly AHF patients. We enrolled 195 patients aged 75 years or older admitted for AHF. The CONUT score, derived from serum albumin, total cholesterol, and total lymphocyte count, was calculated at admission to categorize nutritional status into normal, mild, moderate, or severe malnutrition. The primary endpoint was 2-year all-cause mortality. According to the CONUT score, only 22.1% of patients had normal nutritional status, while 44.6%, 26.7%, and 6.6% exhibited mild, moderate, and severe malnutrition, respectively. At 2 years, cumulative survival rates dropped progressively with increasing malnutrition severity (log-rank p < 0.001). Patients with moderate-to-severe malnutrition (CONUT score greater than or equal to 5) experienced a 48.2% mortality rate. Multivariable Cox proportional hazards analysis confirmed that moderate-to-severe baseline malnutrition was a powerful independent predictor of 2-year all-cause mortality (hazard ratio: 2.24, 95% CI: 1.45–3.48, p < 0.001), after controlling for age, LVEF, eGFR, and NT-proBNP levels. Malnutrition is highly prevalent in elderly patients hospitalized for acute heart failure and represents a critical, independent predictor of poor 2-year survival, suggesting that objective nutritional screening could enhance clinical risk stratification.
Keywords: Acute heart failure, Malnutrition, CONUT score, Elderly, Mortality, Prognosis
Received: November 14, 2012; Revised: December 28, 2012; Accepted: January 15, 2013; Published: February 20, 2013
Citation: International Journal of Cardiology, 2013, Vol. 4, No. 2, pp. 9–16, DOI: 10.46882/2013/IJC/000047