Malnutrition and associated factors among heart failure patients on follow up at Jimma university specialized hospital, Ethiopia

Abstract

BackgroundMalnutrition and cachexia are serious consequences of numerous chronic diseases. Severe heart failure patients could be related with marked weight loss. Malnutrition is associated with poor prognosis among heart failure patients. Despite its implication, factors associated with malnutrition among heart failure patients in Africa and Ethiopia was not addressed. Hence, in this study we tried to determine factors associated with malnutrition among heart failure patients on follow up at Jimma University specialized hospital, Ethiopia.MethodsA cross-sectional study was done on 284 randomly selected heart failure patients. The nutritional status of the patients was assessed based on their serum albumin level (normal value 4–5 mg/dl) and triceps skin fold thickness. The data was analyzed using SPSS version 20.0. Multivariable logistic regression was used to identify factors associated with malnutrition among heart failure patients using SPSS 20.0.ResultsBased on serum albumin and triceps skin fold thickness, 77.8 % of patients were malnourished. Mean age of the patients was 48.3 ± 15.9 years. The commonest cause of heart failure was ischemic heart disease (34.9 %). Hypertension (36 %) was the commonest co morbid disease. Forty four percent of patients had New York heart association functional class II heart failure. Serum hemoglobin (AOR = 0.77, 95 % CI: 0.67–0.92) was found to be significantly associated with nutritional status of heart failure patients. As serum hemoglobin increases by 1gm/dl, the risk of malnutrition decreased by 15 % (P value = 0.03).ConclusionsThe majority of patients were malnourished. A higher hemoglobin concentration was associated with reduced odds of being malnourished.

Effect of albumin-globulin score and albumin to globulin ratio on survival in patients with heart failure: a retrospective cohort study in China

“… 22 23 Serum ALB is used to access protein malnutrition without calorie malnutrition which did not affect the anthropometric measurements (eg, weight). 24 Malnutrition was found to be associated with worsening of symptoms and poor prognosis. Multiple European studies showed malnourished patients with HF are weaker and experience fatigue earlier.…”

“… 25 26 HF with hypoalbuminaemia, the indicator of malnutrition, was found to be associated with higher New York Heart Association functional class, elevated serum blood urea nitrogen and C reactive protein (CRP). 24 It should be noted that, although hypoalbuminaemia might reflect poor nutritional status, ALB reduction in chronic inflammation is frequent. 11 …”

Relationship between enteral nutrition and serum levels of inflammatory factors and cardiac function in elderly patients with heart failure

“…Researches at AMARE and others also proved that malnutrition had greater influence on elderly patients with heart failure. 15 Applied at early stages, enteral nutrition energy metabolism regulation therapy could considerably improve patients’ life quality. 16 Also, the time period of enteral nutrition therapy was closely related to the improvement of patients’ nutrition status.…”

Pediatric Heart Failure, Lagging, and Sagging of Care in Low Income Settings: A Hospital Based Review of Cases in Ethiopia

“…Seventy-nine percent of the patients had malnutrition based on weight for height measurements. According to a report of heart failure patients in adults by Amare et al from Jimma University, in South-West Ethiopia, 77.8% of the these patients were malnourished [33]. It has been reported that the risk of death associated with heart failure is significantly increased in patients at risk of malnutrition or with concomitant malnutrition [34].…”