Handgrip strength in patients with acute decompensated heart failure: Accuracy as a predictor of malnutrition and prognostic value.

Autor: Parahiba SM; Graduate Program in Food, Nutrition and Health, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil., Spillere SR; Multiprofessional Health Residency Program/Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil., Zuchinali P; Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada., Padilha GDR; Nutrition and Dietetic Service/Instituto de Cardiologia - Fundação Universitária de Cardiologia (IC-FUC), Porto Alegre, Brazil., Duarte MB; Nutrition and Dietetic Service/Instituto de Cardiologia - Fundação Universitária de Cardiologia (IC-FUC), Porto Alegre, Brazil., da Silveira IV; Nutrition and Dietetic Service/Instituto de Cardiologia - Fundação Universitária de Cardiologia (IC-FUC), Porto Alegre, Brazil; Graduate Program in Health Sciences: Cardiology, Instituto de Cardiologia - Fundação Universitária de Cardiologia (IC-FUC), Porto Alegre, Brazil., Dias LH; Department of Nutrition, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Knobloch IDS; Department of Nutrition, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil., Perry IS; Food and Nutrition Research Center, Hospital de Clínicas de Porto Alegre/Federal University of Rio Grande do Sul, Porto Alegre, Brazil., Souza GC; Graduate Program in Food, Nutrition and Health, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Nutrition, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Food and Nutrition Research Center, Hospital de Clínicas de Porto Alegre/Federal University of Rio Grande do Sul, Porto Alegre, Brazil. Electronic address: gcsouza@hcpa.edu.br.
Jazyk: angličtina
Zdroj: Nutrition (Burbank, Los Angeles County, Calif.) [Nutrition] 2021 Nov-Dec; Vol. 91-92, pp. 111352. Date of Electronic Publication: 2021 May 26.
DOI: 10.1016/j.nut.2021.111352
Abstrakt: Objectives: The aim of this study was to determine whether handgrip strength (HGS) has diagnostic accuracy for malnutrition assessment and whether it is an independent predictor of 90-d mortality in patients with acute decompensated heart failure (ADHF).
Methods: This cohort study evaluated patients with ADHF within 36 h of hospital admission. Subjective global assessment and handgrip dynamometry were performed and the patients' medical records were analyzed. Mortality was monitored by phone contact and/or medical record search after 90 d. Diagnostic accuracy was tested with receiver operating characteristic (ROC) curves, and survival was tested in a Cox model.
Results: The sample consisted of 161 patients with ADHF who were predominantly male (62%) and older (77%), with a mean age of 68 y (60-75 y) and an ejection fraction of 37.7% ± 16.2%. According to subjective global assessment, 60% were suspected of malnourishment or were moderately or severely malnourished and these patients had lower HGS values than the well-nourished patients (P < 0.001). The ROC curve for HGS was sufficiently accurate to assess malnutrition (area under the curve [AUC] = 0.696; 95% confidence interval [CI], 0.614-0.779; P < 0.001) and had very good accuracy to predict severe malnutrition (AUC = 0.817; 95% CI, 0.711-0.923, P < 0.001). When analyzed by sex, HGS could only accurately detect malnutrition in men, although it could detect severe malnutrition in both men and women. During the 90-d follow-up period, there were 16 deaths (9.9%). An HGS cutoff value of 25.5 kg for men was considered significant for 90-d mortality (hazard ratio, 8.6; 95% CI, 1.1-70.9; P = 0.045).
Conclusion: The results suggested that HGS is an independent indicator of malnutrition in patients with ADHF and can serve as a prognostic marker of 3-mo mortality in men.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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