[Impact of malnutrition on long-term mortality in outpatients with chronic heart failure]. / Influencia de la desnutrición sobre la mortalidad a largo plazo en pacientes ambulatorios con insuficiencia cardiaca crónica.

BACKGROUND: Undernutrition is common among acute heart failure patients and its prognosis impact has been established. The prognosis role of undernutrition among chronic heart failure patients is not known. Objetive:The aim of this study were to evaluate the influence of nutritional status on long-term mortality in patients with chronic hear failure. METHODS: 304 consecutively patients attended in our Heart failure Unit from November 2011 to November 2016 were prospectively analysed. A global nutritional assessment was performed and the states of undernutrition and at risk of malnutrition were assessment by the Mini Nutritional Assessment test. Their possible independent association with mortality was analyzed by Cox multivariate analysis. RESULTS: The mean age was 74.6 ± 10.1 years, 41.1% were female and the most frequent aetiology was ischemic heart disease (39.1%). 11.5% of the patients were classified as undernourished and 38.2% were classified as at risk of malnutrition. The remaining 50.3% were classified by the MNA as adequate nutritional status. After 28 months (median of follow-up), mortality was 68.9%, 33.3% and 15.2%, respectively (Log-rank, p < 0.001). When Cox multivariate analysis was performed, the state of undernutrition was an independent predictor of mortality (Hazard ratio 2.73; 95% confidence interval, 1.55-4.81; p < 0.001). CONCLUSIONS: The prevalence of undernutrition and risk of malnutrition reaches high levels in chronic heart failure patients. Moreover, the state of undernutrition by Mini Nutritional Assessment score is an independent predictor of mortality in these patients.

Influencia de la desnutrición sobre la mortalidad a largo plazo en pacientes ambulatorios con insuficiencia cardiaca crónica / Impact of malnutrition on long-term mortality in outpatients with chronic heart failure

Introducción: la desnutrición es frecuente entre los pacientes con insuficiencia cardiaca aguda y su papel pronóstico ha quedado establecido, no así en el paciente con insuficiencia cardiaca crónica estable. Objetivo: el objetivo de este estudio fue analizar la influencia del estado nutricional sobre la mortalidad a largo plazo en pacientes con insuficiencia cardiaca crónica estable. Métodos: se analizaron prospectivamente 304 pacientes atendidos consecutivamente en la Unidad de Insuficiencia Cardiaca de nuestro centro, entre noviembre de 2011 y noviembre de 2016. Se ejecutó una completa valoración nutricional y se realizó el diagnóstico de desnutrición y riesgo de desnutrición mediante la encuesta Mini Nutritional Assessment. Su posible asociación independiente con la mortalidad se valoró mediante un análisis multivariante de Cox. Resultados: la edad media fue 74,6 ± 10,1 años. El 41,1% fueron mujeres y la etiología más frecuente fue la isquémica (39,1%). El 11,5% de los pacientes fueron clasificados como desnutridos, el 38,2% en riesgo de desnutrición y el 50,3% bien nutridos. A los 28 meses (mediana de seguimiento), la mortalidad en los tres grupos fue 68,9%, 33,3% y 15,2%, respectivamente (Log-rank, p < 0,001). En el análisis multivariante de Cox, el estado de desnutrición resultó ser un predictor independiente de mortalidad (Hazard ratio 2,73; intervalo de confianza 95%, 1,55-4,81; p < 0,001). Conclusiones: la desnutrición y el riesgo de desnutrición alcanzan una prevalencia elevada en pacientes con insuficiencia cardiaca crónica. Además, el estado de desnutrición definido mediante la encuesta Mini Nutritional Assessment es un predictor independiente de mortalidad en estos pacientes (AU)

Background: Undernutrition is common among acute heart failure patients and its prognosis impact has been established. The prognosis role of undernutrition among chronic heart failure patients is not known. Objetive: The aim of this study were to evaluate the influence of nutritional status on long-term mortality in patients with chronic hear failure. Methods: 304 consecutively patients attended in our Heart failure Unit from November 2011 to November 2016 were prospectively analysed. A global nutritional assessment was performed and the states of undernutrition and at risk of malnutrition were assessment by the Mini Nutritional Assessment test. Their possible independent association with mortality was analyzed by Cox multivariate analysis. Results: The mean age was 74.6 ± 10.1 years, 41.1% were female and the most frequent aetiology was ischemic heart disease (39.1%). 11.5% of the patients were classified as undernourished and 38.2% were classified as at risk of malnutrition. The remaining 50.3% were classified by the MNA as adequate nutritional status. After 28 months (median of follow-up), mortality was 68.9%, 33.3% and 15.2%, respectively (Log-rank, p < 0.001). When Cox multivariate analysis was performed, the state of undernutrition was an independent predictor of mortality (Hazard ratio 2.73; 95% confidence interval, 1.55-4.81; p < 0.001). Conclusions: The prevalence of undernutrition and risk of malnutrition reaches high levels in chronic heart failure patients. Moreover, the state of undernutrition by Mini Nutritional Assessment score is an independent predictor of mortality in these patients (AU)