ISSN 2996-8215
International Journal of Cardiology | Vol. 17, No. 2, February 2026 | pp. 9–16
DOI: 10.46882/2026/IJC/000202
Original Research Article
Controlled Nutro-Biometric Layering via Multi-Parametric Evaluation Panels for Risk Screening in Geriatric Congestion
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 frequently complicates heart failure progression in geriatric populations, precipitating severe cardiac cachexia. Despite its high prevalence, routine nutritional screening is rarely integrated into acute heart failure (AHF) admissions. This prospective study evaluated the clinical utility of the Controlling Nutritional Status (CONUT) score for predicting 3-year survival dynamics in elderly individuals hospitalized for AHF. We evaluated 210 patients aged 75 years or older admitted with primary AHF. The baseline CONUT score was calculated from automated serum albumin, total cholesterol, and absolute lymphocyte counts, stratifying patients into normal, mild, moderate, or severe nutritional risk categories. The primary clinical endpoint was 36-month all-cause mortality. Normal nutritional status was identified in only 21.4% of the cohort, while mild, moderate, and severe malnutrition risks were present in 43.8%, 28.1%, and 6.7% of patients, respectively. Over 3 years, all-cause mortality rose progressively with increasing malnutrition severity (log-rank p < 0.001). Patients with moderate-to-severe baseline malnutrition (CONUT score greater than or equal to 5) experienced an overall mortality rate of 51.4%. Multivariable Cox proportional hazards analysis confirmed that moderate-to-severe CONUT status was a powerful independent predictor of 3-year mortality (hazard ratio: 2.15, 95% CI: 1.32–3.52, p = 0.002), after adjusting for age, LVEF, eGFR, and admission NT-proBNP levels. Objective nutritional risk calculation using the CONUT score provides robust independent prognostic data in geriatric acute heart failure cohorts.
Keywords: Acute heart failure, Malnutrition, CONUT score, Geriatric cardiology, Mortality, Prognosis
Received: November 14, 2025; Revised: December 28, 2025; Accepted: January 15, 2026; Published: February 20, 2026