Home-Delivered Meals Postdischarge From Heart Failure Hospitalization
| Autor: | Scott L, Hummel, Wahida, Karmally, Brenda W, Gillespie, Stephen, Helmke, Sergio, Teruya, Joanna, Wells, Erika, Trumble, Omar, Jimenez, Cara, Marolt, Jeffrey D, Wessler, Maria L, Cornellier, Mathew S, Maurer |
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| Rok vydání: | 2018 |
| Předmět: |
Heart Failure
Male Michigan Cardiac Rehabilitation Time Factors Dietary Approaches To Stop Hypertension Malnutrition Age Factors Food Services Nutritional Status Diet Sodium-Restricted Patient Readmission Patient Discharge Treatment Outcome Surveys and Questionnaires Quality of Life Humans Female New York City Geriatric Assessment Meals Nutritive Value Aged |
| Zdroj: | Circulation. Heart failure. 11(8) |
| ISSN: | 1941-3297 |
| 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 |
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