Nutritional status during hospitalization is associated with the long‐term prognosis of patients with heart failure

Abstract

Aims The CONtrolling NUTritional status (CONUT) score represents the nutritional status of patients with heart failure (HF). Although high CONUT scores on admission are associated with increased risks of cardiovascular (CV) events in patients with HF, the impact of CONUT changes during hospitalization on their long‐term prognosis is unclear. This study aimed to investigate the impact of CONUT score changes on the clinical outcomes of patients with HF after discharge. Methods and results This observational study included 1705 patients hospitalized with HF who were discharged alive. The patients were categorized depending on their CONUT scores at admission and discharge into persistently high, high at admission and normal at discharge, normal at admission and high at discharge, and persistently normal CONUT groups. The primary endpoint was a composite of CV death and readmission for HF after discharge. The primary endpoint occurred in 652 patients (38%) during the median 525 day follow‐up period. Patients with persistently high CONUT scores had the highest composite endpoint rate (log‐rank trend test: P < 0.001). After adjusting for covariates, the hazard ratio for the composite outcome was significantly lower for the patients with high CONUT scores at admission and normal CONUT scores at discharge than that for those with persistently high CONUT scores (hazard ratio: 0.69; 95% confidence interval: 0.49–0.98). Conclusions Nutritional status changes in patients with HF that occurred during hospitalization were associated with CV events after discharge. Improving the nutritional status of patients may improve their clinical outcomes.

The controlling nutritional status score and clinical outcomes in patients with heart failure: Pool analysis of observational studies

“…Two investigators (XH and YH) independently screened the titles and abstracts. Then, 62 potentially related full articles were reviewed, and 18 studies were finally included in the pooled analysis according to the pre-defined criteria ( Figure 1 ) ( 12 – 16 , 24 – 36 ). There were 12,532 participants with HF in the included studies, with a median follow-up duration of 32.5 months.…”

Prognostic Value of Cheyne-Stokes Respiration and Nutritional Status in Acute Decompensated Heart Failure

“…CONUT score was calculated according to the original study [ 19 ]. We defined patients without malnutrition as CONUT score 0–1 point (normal) and with malnutrition as 2–12 points (including mild, moderate and severe), which is similar to a recent study classification method [ 21 ].…”

The clinical value of the Controlling Nutritional Status score for predicting prognosis in systolic heart failure cases in the vulnerable phase

“…Malnutrition, which decreases the quality of life and prognosis, is prevalent among hospitalized elderly HF cases, especially in advanced disease stages ( 4 ). A specific nutritional strategy is still being explored, although not mentioned by any of the existing HF guidelines; while nutritional status assessment is recommended, HF patients would benefit from early nutritional intervention ( 5 , 6 ).…”

“…The Controlling Nutritional Status (CONUT) score, which is based on serum albumin amounts, lymphocyte content, and total cholesterol amounts, is a comprehensive and objective nutritional screening tool, which can be used to examine protein reserves, calorie depletion, and immune function ( 7 ). In patients with HF, CONUT score predicts long-term prognosis ( 4 ). The nutritional status of HF cases after discharge may be greatly affected by daily diet care, so the CONUT score might have elevated potential in predicting early prognosis after discharge as a nutritional screening tool.…”