Home-Delivered Meals Postdischarge From Heart Failure Hospitalization
| Autor: | Mathew S. Maurer, Wahida Karmally, Cara Marolt, Maria L. Cornellier, Jeffrey D. Wessler, Scott L. Hummel, Omar Jimenez, Brenda W. Gillespie, Joanna M. Wells, Erika Trumble, Stephen Helmke, Sergio Teruya |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Ejection fraction Hyperkalemia business.industry Acute kidney injury 030204 cardiovascular system & hematology medicine.disease Clinical trial 03 medical and health sciences Malnutrition 0302 clinical medicine Internal medicine Heart failure Dash medicine 030212 general & internal medicine medicine.symptom Cardiology and Cardiovascular Medicine Adverse effect business |
| Zdroj: | Circulation: Heart Failure. 11 |
| ISSN: | 1941-3297 1941-3289 |
| DOI: | 10.1161/circheartfailure.117.004886 |
| Popis: | Background In patients with heart failure (HF), malnutrition and dietary sodium excess are common and may worsen outcomes. No prior studies have provided low-sodium, nutritionally complete meals following HF hospitalization. Methods and Results The GOURMET-HF study (Geriatric Out-of-Hospital Randomized Meal Trial in Heart Failure) randomized patients discharged from HF hospitalization to 4 weeks of home-delivered sodium-restricted Dietary Approaches to Stop Hypertension meals (DASH/SRD; 1500 mg sodium/d) versus usual care. The primary outcome was the between-group change in the Kansas City Cardiomyopathy Questionnaire summary score from discharge to 4 weeks postdischarge. Additional outcomes included changes in the Kansas City Cardiomyopathy Questionnaire clinical summary score and cardiac biomarkers. All patients were followed 12 weeks for death/all-cause readmission and potential diet-related adverse events (symptomatic hypotension, hyperkalemia, acute kidney injury). Sixty-six patients were randomized 1:1 at discharge to DASH/SRD versus usual care (age, 71±8 years; 30% female; ejection fraction, 39±18%). The Kansas City Cardiomyopathy Questionnaire summary score increased similarly between groups (DASH/SRD 46±23–59±20 versus usual care 43±19–53±24; P =0.38), but the Kansas City Cardiomyopathy Questionnaire clinical summary score increase tended to be greater in DASH/SRD participants (47±22–65±19 versus 45±20–55±26; P =0.053). Potentially diet-related adverse events were uncommon; 30-day HF readmissions (11% versus 27%; P =0.06) and days rehospitalized within that timeframe (17 versus 55; P =0.055) trended lower in DASH/SRD participants. Conclusions Home-delivered DASH/SRD after HF hospitalization appeared safe in selected patients and had directionally favorable effects on HF clinical status and 30-day readmissions. Larger studies are warranted to clarify the effects of postdischarge nutritional support in patients with HF. Clinical Trial Registration URL: https://www.clinicaltrials.gov . Unique identifier: NCT02148679. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|