The prevalence of malnutrition and its effects on the all-cause mortality among patients with heart failure: A systematic review and meta-analysis

Lv, Shubin; Ru, Song‐Chao

doi:10.1371/journal.pone.0259300

Cited by 31 publications

(18 citation statements)

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“… 15 The MNA‐SF, GNRI, and CONUT scores are representative nutritional screening methods that have been validated in several studies in HF patients. 4 , 5 , 7 , 9 , 10 , 11 The present study suggests that the MNA‐SF score is the most appropriate first choice for nutritional screening of HF patients because it had the highest diagnostic performance for the assessment of nutritional status in accordance with the GLIM criteria in our study ( Figure 3 ). One possible reason for the inferiority of the GNRI and CONUT scores is that these indicators are only assessed by objective measures such as blood tests or BMI at a single point and do not include temporal or subjective nutritional information.…”

Section: Discussionmentioning

confidence: 59%

“…These nutritional indicators are representative nutritional screening methods that have been validated in several studies in HF patients. 4 , 5 , 7 , 9 , 10 The MNA‐SF is a simple nutritional screening tool, consisting of six questionnaire items. The MNA‐SF score ranges from 0 to 14 points, and patients with a score of 12 or less were defined as at nutritional risk, as previously described.…”

Section: Methodsmentioning

confidence: 99%

“… 4 , 5 , 6 Although the nutritional assessment of HF patients has not been well established, 7 recent studies have reported that various types of nutritional indicators, such as the mini nutritional assessment‐short form (MNA‐SF), geriatric nutritional risk index (GNRI), and controlling nutritional status (CONUT) scores, are useful for predicting the prognosis of HF patients. 7 , 8 , 9 , 10 , 11 However, most reports have only examined the association between these nutritional indicators and prognosis as a surrogate marker of nutritional status. 7 Few reports have directly evaluated the association of these nutritional indicators with body composition or physical function, which can both reflect actual nutritional status and its related functional disorders.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic performance of nutritional indicators in patients with heart failure

et al. 2022

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Aims The aim of this study was to compare the diagnostic performance of the nutritional indicators, the mini nutritional assessment‐short form (MNA‐SF), the geriatric nutritional risk index (GNRI), and the controlling nutritional status (CONUT), in heart failure (HF) patients. Methods and results Nutritional status was prospectively assessed by the aforementioned three nutritional indicators in 150 outpatients with HF who were then followed for 1 year. The prevalence of patients with the nutritional risk as assessed by the MNA‐SF, GNRI, and CONUT scores was 50.0%, 13.3%, and 54.0%, respectively. There was slight agreement of nutritional risk assessment between the MNA‐SF and GNRI scores (κ coefficient = 0.16), as well as the GNRI and CONUT scores (κ = 0.11), but poor agreement between the MNA‐SF and CONUT scores (κ = −0.09). The CONUT score had the lowest area under the curve (AUC) for the identification of low body weight, low muscle mass, and low physical function among the three indicators (all P < 0.05). Compared with the MNA‐SF score, both the GNRI and CONUT scores had lower AUCs for the identification of reduced dietary intake and weight loss (all P < 0.05). There was no significant difference in predicting all‐cause mortality or HF rehospitalization among the three indicators. The prescription of statins reduced the diagnostic performance of the CONUT score, as the CONUT score includes cholesterol level assessment. Conclusions Of the three indicators, the diagnostic ability of the MNA‐SF score was the highest, and that of the CONUT score was the lowest, for the assessment of HF patient nutritional status. The CONUT score may misrepresent nutritional status, particularly in patients receiving statins.

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Section: Discussionmentioning

confidence: 59%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnostic performance of nutritional indicators in patients with heart failure

et al. 2022

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“…Despite advances in medicine, heart failure (HF) remains an increasing public health problem associated with high morbidity and mortality 1 . Malnutrition has been reported as common and associated with poor clinical outcomes in patients with HF 2 . Objective nutritional assessments have been recommended in patients with HF, such as the prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI) and controlling nutritional status (CONUT) score 3 – 5 .…”

Section: Introductionmentioning

confidence: 99%

Association of malnutrition with renal dysfunction and clinical outcome in patients with heart failure

Otaki

Watanabe

Shimizu

et al. 2022

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Malnutrition, glomerular damage (GD), and renal tubular damage (RTD) are common morbidities associated with poor clinical outcomes in heart failure (HF) patients. However, the association between malnutrition and renal dysfunction and its impact on clinical outcomes in HF patients have not yet been fully elucidated. We assessed the nutritional status and renal function of 1061 consecutive HF patients. Malnutrition, GD, and RTD were defined as a controlling nutritional status (CONUT) score of ≥ 5, reduced eGFR or microalbuminuria, and levels of N-acetyl-beta-d-glucosamidase of > 14.2 U/gCr according to previous reports, respectively. Patients with RTD had a higher CONUT score and a lower prognostic nutritional index and geriatric nutritional risk index than those without. Multivariate logistic analysis demonstrated that RTD, but not GD, was significantly associated with malnutrition. There were 360 cardiac events during the median follow-up period of 688 days. Multivariate Cox proportional hazard regression analysis demonstrated that comorbid malnutrition and renal dysfunction, rather than simple malnutrition, were significantly associated with cardiac events in HF patients. We found a close relationship between malnutrition and renal dysfunction in HF patients. Comorbid malnutrition and renal dysfunction were risk factors for cardiac events in HF patients, suggesting the importance of managing and treating these.

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“…It is triggered by poor nutritional intake, malabsorption, systemic inflammation, neurohumoral activation, oxidative stress, and augmented catabolic process (4)(5)(6)(7). Malnutrition in heart failure is associated with higher hospital readmission rates and increased mortality rates (7)(8)(9)(10)(11)(12). Obese individuals with heart failure were paradoxically associated with improved cardiovascular outcomes and survival, which is referred to as the obesity paradox.…”

Section: Introductionmentioning

confidence: 99%

Undernutrition was a prevalent clinical problem among older adult patients with heart failure in a hospital setting in Northwest Ethiopia

et al. 2022

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BackgroundUndernutrition is a frequently noticed medical problem in patients with heart failure. It is caused by poor nutrient intake, malabsorption, systemic inflammation, neurohumoral activation, oxidative stress, and hypermetabolic state. Undernutrition results in a decrease in the quality of life and the survival rate in patients with heart failure. There is a paucity of documentation on undernutrition among patients with heart failure in sub-Saharan African countries. The study aimed to determine the magnitude and associated factors of undernutrition among older adult patients with heart failure in the hospital setting in Northwest Ethiopia.MethodsAn institutional-based cross-sectional study was conducted at the University of Gondar Hospital, Northwest Ethiopia, between 1 June 2021 and 31 October 2021. A consecutive sampling method was used to recruit 262 study subjects. A Mini-nutritional assessment-full form (MNA-FL) Questionnaire was used to extract nutritional information among patients with heart failure. Patients with heart failure, who scored MNA-FL score <17, were declared to have undernutrition. The data were entered into EPI Info version 4.6.0.0 and then exported to SPSS version 26 for analysis. Explanatory variables associated with undernutrition in patients with heart failure were analyzed by applying a logistic regression model. A P-value of <0.05 was used to declare a significant association.ResultsA total of 262 patients with heart failure were included in the study. The mean age (± SD) of the study subjects was 64.6 (± 9.2) years. Hypertensive heart disease (111/262, 42%) was the most common cause of heart failure. Hypertension was the frequently observed comorbid disease. Based on the MNA-FL score for nutritional status, 75 out of 262 (28.6%, 95% CI: 22.9–34.4%) were undernourished (MNA-FL < 17), while 124 out of 262 (47.3%, CI: 41.5–53.1%) were at risk of undernutrition (MNA-FL = 17–23.5). The remaining 63 out of 262 (24.1%, 95% CI: 18.2–29.8%) study subjects were well nourished (MNA-FL > 24). On a multivariate analysis, patients with severe heart failure (New York Heart Association (NYHA) functional class III/IV) (AOR = 4.287, CI: 2.012–9.134, P-value < 0.001), with a duration of illness of 3–5 years (AOR = 3.225, CI: 1.138–9.137, P-value = 0.028), with a duration of illness of >5 years (AOR = 4.349, CI: 1.592–11.879, P-value = 0.001), presence of comorbidities (AOR = 2.29, CI: 1.06–4.96, P-value = 0.036), who underwent treatment with loop diuretics (AOR = 2.983, CI: 1.407–6.326, P-value = 0.040), and who reside in a rural area (AOR = 5.119, CI: 2.481–10.560, P-value < 0.001) were at risk of developing undernutrition.ConclusionUndernutrition was a significant clinical problem in older patients with heart failure. Nutritional interventions should be prioritized for patients with chronic and severe heart failure.

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The prevalence of malnutrition and its effects on the all-cause mortality among patients with heart failure: A systematic review and meta-analysis

Cited by 31 publications

References 31 publications

Diagnostic performance of nutritional indicators in patients with heart failure

Diagnostic performance of nutritional indicators in patients with heart failure

Association of malnutrition with renal dysfunction and clinical outcome in patients with heart failure

Undernutrition was a prevalent clinical problem among older adult patients with heart failure in a hospital setting in Northwest Ethiopia

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