Effect of risk of malnutrition on 30-day mortality among older patients with acute heart failure in Emergency Departments.

Autor: Martín-Sánchez FJ; 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., Cuesta Triana F; 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., Rossello X; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain., Pardo García R; Universidad Complutense de Madrid, Madrid, Spain., Llopis García G; Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain., Caimari F; Department of Endocrinology, University College London, Hospitals NHS Foundation Trust, London, UK., Vidán MT; 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., Ruiz Artacho P; Department of Internal Medicine, Clínica Universitaria de Navarra, Madrid, Spain., González Del Castillo J; Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain., Llorens P; Emergency Department-UCE-UHD, Hospital General Universitario de Alicante, Alicante, Spain., Herrero P; Emergency Department, Hospital Central de Asturias, Oviedo, Asturias, Spain., Jacob J; Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain., Gil V; Emergency Department, Hospital Clínic, Institut de Recerca Biomédica August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain., Fernández Pérez C; Universidad Complutense de Madrid, Madrid, Spain; Preventive Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain., Gil P; 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., Bueno H; 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., Miró Ò; Emergency Department, Hospital Clínic, Institut de Recerca Biomédica August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain., Matía Martín P; 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., Rodríguez Adrada E; Hospital Clínico San Carlos, Madrid, Spain., Santos MC; Hospital Clínico San Carlos, Madrid, Spain., Salgado L; Hospital Clínico San Carlos, Madrid, Spain., Brizzi BN; Hospital Clínico San Carlos, Madrid, Spain., Docavo ML; Hospital Clínico San Carlos, Madrid, Spain., Del Mar Suárez-Cadenas M; Hospital Clínico San Carlos, Madrid, Spain., Xipell C; Hospital Clínic, Barcelona, Spain., Sánchez C; Hospital Clínic, Barcelona, Spain., Aguiló S; Hospital Clínic, Barcelona, Spain., Gaytan JM; Hospital Clínic, Barcelona, Spain., Jerez A; Hospital Clínic, Barcelona, Spain., Pérez-Durá MJ; Hospital La Fe, Valencia, Spain., Berrocal Gil P; Hospital La Fe, Valencia, Spain., López-Grima ML; Hospital Dr. Peset, Valencia, Spain., Valero A; Hospital Dr. Peset, Valencia, Spain., Aguirre A; Hospital del Mar, Barcelona, Spain., Pedragosa MÀ; Hospital del Mar, Barcelona, Spain., Piñera P; Hospital Reina Sofía, Murcia, Spain., LázaroAragues P; Hospital Reina Sofía, Murcia, Spain., Sánchez Nicolás JA; Hospital Reina Sofía, Murcia, Spain., Rizzi MA; Hospital de la Santa Creu y Sant Pau, Barcelona, Spain., Herrera Mateo S; Hospital de la Santa Creu y Sant Pau, Barcelona, Spain., Alquezar A; Hospital de la Santa Creu y Sant Pau, Barcelona, Spain., Roset A; Hospital Universitari de Bellvitge, Barcelona, Spain., Ferrer C; Hospital Universitari de Bellvitge, Barcelona, Spain., Llopis F; Hospital Universitari de Bellvitge, Barcelona, Spain., Álvarez Pérez JM; Hospital Universitario, Burgos, Spain., López Diez MP; Hospital Universitario, Burgos, Spain., Richard F; Hospital Universitario, Burgos, Spain., Fernández-Cañadas JM; Hospital Universitario General de Alicante, Alicante, Spain., Carratalá JM; Hospital Universitario General de Alicante, Alicante, Spain., Javaloyes P; Hospital Universitario General de Alicante, Alicante, Spain., Andueza JA; Hospital General Universitario Gregorio Marañón, Madrid, Spain., Sevillano Fernández JA; Hospital General Universitario Gregorio Marañón, Madrid, Spain., Romero R; Hospital Getafe, Madrid, Spain., Merlo Loranca M; Hospital Getafe, Madrid, Spain., Álvarez Rodríguez V; Hospital Getafe, Madrid, Spain., Lorca MT; Hospital del Tajo, Madrid, Spain., Calderón L; Hospital del Tajo, Madrid, Spain., Soy Ferrer E; Hospital JosepTrueta, Girona, Spain., Manuel Garrido J; Hospital Virgen de la Macarena, Sevilla, Spain., Martín Mojarro E; Hospital Sant Pau i Santa Tecla, Tarragona, Spain.
Jazyk: angličtina
Zdroj: European journal of internal medicine [Eur J Intern Med] 2019 Jul; Vol. 65, pp. 69-77. Date of Electronic Publication: 2019 May 07.
DOI: 10.1016/j.ejim.2019.04.014
Abstrakt: 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.
(Copyright © 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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