The Association between Nutritional Status and In-Hospital Mortality among Patients with Heart Failure—A Result of the Retrospective Nutritional Status Heart Study 2 (NSHS2)

Czapla, Michał; Juárez‐Vela, Raúl; Łokieć, Katarzyna; Karniej, Piotr

doi:10.3390/nu13051669

Cited by 23 publications

(24 citation statements)

References 42 publications

(42 reference statements)

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“…This finding supported the "obesity paradox" that overweight/obese patients could have superior survival. It was first proposed by Fleischmann et al (18) in patients undergoing hemodialysis (18) and further validated in subjects with chronic diseases, such as cardiovascular diseases, hypertension, and diabetes (19)(20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

Effect of Body Mass Index on the Prognosis of Liver Cirrhosis

Yin

Shao³

et al. 2021

Front. Nutr.

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Objective: At present, the association of body mass index (BMI) with the prognosis of liver cirrhosis is controversial. Our retrospective study aimed to evaluate the impact of BMI on the outcome of liver cirrhosis.Methods: In the first part, long-term death was evaluated in 436 patients with cirrhosis and without malignancy from our prospectively established single-center database. In the second part, in-hospital death was evaluated in 379 patients with cirrhosis and with acute gastrointestinal bleeding (AGIB) from our retrospective multicenter study. BMI was calculated and categorized as underweight (BMI <18.5 kg/m2), normal weight (18.5 ≤ BMI < 23.0 kg/m2), and overweight/obese (BMI ≥ 23.0 kg/m2).Results: In the first part, Kaplan–Meier curve analyses demonstrated a significantly higher cumulative survival rate in the overweight/obese group than the normal weight group (p = 0.047). Cox regression analyses demonstrated that overweight/obesity was significantly associated with decreased long-term mortality compared with the normal weight group [hazard ratio (HR) = 0.635; 95% CI: 0.405–0.998; p = 0.049] but not an independent predictor after adjusting for age, gender, and Child–Pugh score (HR = 0.758; 95%CI: 0.479–1.199; p = 0.236). In the second part, Kaplan–Meier curve analyses demonstrated no significant difference in the cumulative survival rate between the overweight/obese and the normal weight groups (p = 0.094). Cox regression analyses also demonstrated that overweight/obesity was not significantly associated with in-hospital mortality compared with normal weight group (HR = 0.349; 95%CI: 0.096-1.269; p = 0.110). In both of the two parts, the Kaplan–Meier curve analyses demonstrated no significant difference in the cumulative survival rate between underweight and normal weight groups.Conclusion: Overweight/obesity is modestly associated with long-term survival in patients with cirrhosis but not an independent prognostic predictor. There is little effect of overweight/obesity on the short-term survival of patients with cirrhosis and with AGIB.

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Section: Discussionmentioning

confidence: 99%

Effect of Body Mass Index on the Prognosis of Liver Cirrhosis

Yin

Shao³

et al. 2021

Front. Nutr.

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“…Malnutrition in cancer patients may depend on several mechanisms, including the tumor type, disease stage, side effects related to the treatment, and inadequate nutritional therapy [43,44]. Moreover, heart failure or diabetes mellitus are common diseases with a high prevalence of malnutrition and higher in-hospital mortality rates [45][46][47][48]. Polypharmacy is associated with malnutrition, especially proton pump inhibitors, anti-constipation, and antihypertensive drugs [49].…”

Section: Risk Factors For Malnutrition In Hospitalized Patientsmentioning

confidence: 99%

Malnutrition in Hospitalized Old Patients: Screening and Diagnosis, Clinical Outcomes, and Management

et al. 2022

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Malnutrition in hospitalized patients heavily affects several clinical outcomes. The prevalence of malnutrition increases with age, comorbidities, and intensity of care in up to 90% of old populations. However, malnutrition frequently remains underdiagnosed and undertreated in the hospital. Thus, an accurate screening to identify patients at risk of malnutrition or malnourishment is determinant to elaborate a personal nutritional intervention. Several definitions of malnutrition were proposed in the last years, affecting the real frequency of nutritional disorders and the timing of intervention. Diagnosis of malnutrition needs a complete nutritional assessment, which is often challenging to perform during a hospital stay. For this purpose, various screening tools were proposed, allowing patients to be stratified according to the risk of malnutrition. The present review aims to summarize the actual evidence in terms of diagnosis, association with clinical outcomes, and management of malnutrition in a hospital setting.

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“…Recently, several studies show that malnutrition is correlated with increased in-hospital mortality, long-term mortality and cardiovascular events of acute coronary syndrome (ACS), acute myocardial infarction (AMI), acute heart failure (HF), chronic heart failure, and atrial fibrillation (AF) [ 2 – 8 ]. Malnutrition is also a significant and common comorbidity in diabetic patients, and it is associated with in-hospital mortality and long-term outcomes [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and prognostic significance of malnutrition in diabetic patients with coronary artery disease: a cohort study

Wei

Zhang²,

Li³

et al. 2021

Nutr Metab (Lond)

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Background Malnutrition is associated with poor prognosis in cardiovascular disease patients or in diabetic patients. However, the relationship between malnutrition and clinical outcomes in diabetic patients with coronary artery disease (CAD) is not well known. The aim of this study is to report the prevalence and prognostic consequences of malnutrition in diabetic patients with CAD. Methods In this retrospective observational study, the Controlling Nutritional Status (CONUT) score applied to 12,898 consecutive diabetic patients with CAD. The association between malnutrition and long-term all-cause mortality was examined using Cox proportional hazards regression analysis. Results According to CONUT score, 60.5% patients suffered from malnutrition; 46.4%, 13.2%, and 0.9% patients had mild, moderate, and severe malnutrition, respectively. During a median follow-up of 4.88 (2.83–7.51) years, 1973 (15.3%) patients died. After adjustment for confounders, malnutrition was associated with significantly increased risk for long-term all-cause mortality (adjusted hazard ratio for mild malnutrition and moderate to severe malnutrition, respectively: 1.38 [95% confidence interval (CI) 1.07–1.77]; P value = 0.012 and 1.63 [95% CI 1.18–2.24]; P value = 0.003). A similar association was observed around subgroups. Conclusions Malnutrition is common in diabetic patients with CAD and is strongly associated with increased mortality. It is necessary to adequately assess the nutritional status and take the effective nutritional guidance to improve the prognosis of diabetic patients with CAD.

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The Association between Nutritional Status and In-Hospital Mortality among Patients with Heart Failure—A Result of the Retrospective Nutritional Status Heart Study 2 (NSHS2)

Cited by 23 publications

References 42 publications

Effect of Body Mass Index on the Prognosis of Liver Cirrhosis

Effect of Body Mass Index on the Prognosis of Liver Cirrhosis

Malnutrition in Hospitalized Old Patients: Screening and Diagnosis, Clinical Outcomes, and Management

Prevalence and prognostic significance of malnutrition in diabetic patients with coronary artery disease: a cohort study

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