Francisco Javier Martín-Sánchez1, Federico Cuesta Triana2, Xavier Rossello3, Rebeca Pardo García4, Guillermo Llopis García5, Francisca Caimari6, María Teresa Vidán7, Pedro Ruiz Artacho8, Juan González Del Castillo9, Pere Llorens10, Pablo Herrero11, Javier Jacob12, Víctor Gil13, Cristina Fernández Pérez14, Pedro Gil2, Héctor Bueno15, Òscar Miró13, Pilar Matía Martín16, Esther Rodríguez Adrada17, María Carmen Santos17, Lucía Salgado17, Berenice Nayla Brizzi17, María Luisa Docavo17, María Del Mar Suárez-Cadenas17, Carolina Xipell18, Carolina Sánchez18, Sira Aguiló18, Josep María Gaytan18, Alba Jerez18, María José Pérez-Durá19, Pablo Berrocal Gil19, María Luisa López-Grima20, Amparo Valero20, Alfons Aguirre21, Maria Àngels Pedragosa21, Pascual Piñera22, Paula LázaroAragues22, José Andrés Sánchez Nicolás22, Miguel Alberto Rizzi23, Sergio Herrera Mateo23, Aitor Alquezar23, Alex Roset24, Carles Ferrer24, Ferrán Llopis24, José María Álvarez Pérez25, María Pilar López Diez25, Fernando Richard25, José María Fernández-Cañadas26, José Manuel Carratalá26, Patricia Javaloyes26, Juan Antonio Andueza27, José Antonio Sevillano Fernández27, Rodolfo Romero28, Marta Merlo Loranca28, Virginia Álvarez Rodríguez28, María Teresa Lorca29, Luis Calderón29, Ester Soy Ferrer30, José Manuel Garrido31, Enrique Martín Mojarro32. 1. Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain. Electronic address: fmarti09@ucm.es. 2. Universidad Complutense de Madrid, Madrid, Spain; Department of Geriatric Medicine, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain. 3. Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain. 4. Universidad Complutense de Madrid, Madrid, Spain. 5. Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain. 6. Department of Endocrinology, University College London, Hospitals NHS Foundation Trust, London, UK. 7. Universidad Complutense de Madrid, Madrid, Spain; Department of Geriatric Medicine, Hospital General Universitario Gregorio Marañón, Instituto de Investigación IiSGM, Universidad Complutense de Madrid, Madrid, Spain. 8. Department of Internal Medicine, Clínica Universitaria de Navarra, Madrid, Spain. 9. Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain. 10. Emergency Department-UCE-UHD, Hospital General Universitario de Alicante, Alicante, Spain. 11. Emergency Department, Hospital Central de Asturias, Oviedo, Asturias, Spain. 12. Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. 13. Emergency Department, Hospital Clínic, Institut de Recerca Biomédica August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain. 14. Universidad Complutense de Madrid, Madrid, Spain; Preventive Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain. 15. Universidad Complutense de Madrid, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Cardiology, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain. 16. Universidad Complutense de Madrid, Madrid, Spain; Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain. 17. Hospital Clínico San Carlos, Madrid, Spain. 18. Hospital Clínic, Barcelona, Spain. 19. Hospital La Fe, Valencia, Spain. 20. Hospital Dr. Peset, Valencia, Spain. 21. Hospital del Mar, Barcelona, Spain. 22. Hospital Reina Sofía, Murcia, Spain. 23. Hospital de la Santa Creu y Sant Pau, Barcelona, Spain. 24. Hospital Universitari de Bellvitge, Barcelona, Spain. 25. Hospital Universitario, Burgos, Spain. 26. Hospital Universitario General de Alicante, Alicante, Spain. 27. Hospital General Universitario Gregorio Marañón, Madrid, Spain. 28. Hospital Getafe, Madrid, Spain. 29. Hospital del Tajo, Madrid, Spain. 30. Hospital JosepTrueta, Girona, Spain. 31. Hospital Virgen de la Macarena, Sevilla, Spain. 32. Hospital Sant Pau i Santa Tecla, Tarragona, Spain.
Abstract
BACKGROUND: Little is known about the prevalence and impact of risk of malnutrition on short-term mortality among seniors presenting with acute heart failure (AHF) in emergency setting. The objective was to determine the impact of risk of malnutrition on 30-day mortality risk among older patients who attended in Emergency Departments (EDs) for AHF. MATERIAL AND METHODS: We performed a secondary analysis of the OAK-3 Registry including all consecutive patients ≥65 years attending in 16 Spanish EDs for AHF. Risk of malnutrition was defined by the Mini Nutritional Assessment Short Form (MNA-SF) < 12 points. Unadjusted and adjusted logistic regression models were used to assess the association between risk of malnutrition and 30-day mortality. RESULTS: We included 749 patients (mean age: 85 (SD 6); 55.8% females). Risk of malnutrition was observed in 594 (79.3%) patients. The rate of 30-day mortality was 8.8%. After adjusting for MEESSI-AHF risk score clinical categories (model 1) and after adding all variables showing a significantly different distribution among groups (model 2), the risk of malnutrition was an independent factor associated with 30-day mortality (adjusted OR by model 1 = 3.4; 95%CI 1.2-9.7; p = .020 and adjusted OR by model 2 = 3.1; 95%CI 1.1-9.0; p = .033) compared to normal nutritional status. CONCLUSIONS: The risk of malnutrition assessed by the MNA-SF is associated with 30-day mortality in older patients with AHF who were attended in EDs. Routine screening of risk of malnutrition may help emergency physicians in decision-making and establishing a care plan.
BACKGROUND: Little is known about the prevalence and impact of risk of malnutrition on short-term mortality among seniors presenting with acute heart failure (AHF) in emergency setting. The objective was to determine the impact of risk of malnutrition on 30-day mortality risk among older patients who attended in Emergency Departments (EDs) for AHF. MATERIAL AND METHODS: We performed a secondary analysis of the OAK-3 Registry including all consecutive patients ≥65 years attending in 16 Spanish EDs for AHF. Risk of malnutrition was defined by the Mini Nutritional Assessment Short Form (MNA-SF) < 12 points. Unadjusted and adjusted logistic regression models were used to assess the association between risk of malnutrition and 30-day mortality. RESULTS: We included 749 patients (mean age: 85 (SD 6); 55.8% females). Risk of malnutrition was observed in 594 (79.3%) patients. The rate of 30-day mortality was 8.8%. After adjusting for MEESSI-AHF risk score clinical categories (model 1) and after adding all variables showing a significantly different distribution among groups (model 2), the risk of malnutrition was an independent factor associated with 30-day mortality (adjusted OR by model 1 = 3.4; 95%CI 1.2-9.7; p = .020 and adjusted OR by model 2 = 3.1; 95%CI 1.1-9.0; p = .033) compared to normal nutritional status. CONCLUSIONS: The risk of malnutrition assessed by the MNA-SF is associated with 30-day mortality in older patients with AHF who were attended in EDs. Routine screening of risk of malnutrition may help emergency physicians in decision-making and establishing a care plan.
Authors: Òscar Miró; Xavier Rossello; Elke Platz; Josep Masip; Danielle M Gualandro; W Frank Peacock; Susanna Price; Louise Cullen; Salvatore DiSomma; Mucio Tavares de Oliveira; John Jv McMurray; Francisco J Martín-Sánchez; Alan S Maisel; Christiaan Vrints; Martin R Cowie; Héctor Bueno; Alexandre Mebazaa; Christian Mueller Journal: Eur Heart J Acute Cardiovasc Care Date: 2020-08