Association between the Controlling Nutritional Status score and long-term outcome in patients with acute heart failure.
10.3760/cma.j.cn112148-20211101-00944
- Author:
Xin Yi LU
1
;
Xu Hui CHEANG
1
;
Shen Gen LIAO
1
;
Xu ZHU
1
;
Hai Feng ZHANG
1
;
Yan Li ZHOU
1
;
Wen Ming YAO
1
;
Xin Li LI
1
Author Information
1. Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China.
- Publication Type:Journal Article
- MeSH:
Heart Failure;
Humans;
Nutrition Assessment;
Nutritional Status;
Prognosis;
Prospective Studies;
Retrospective Studies
- From:
Chinese Journal of Cardiology
2021;49(12):1220-1226
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate the nutritional status by the Controlling Nutritional Status (CONUT) score and its association with the long-term prognosis in patients with acute heart failure (AHF). Methods: This prospective monocentric study consecutively enrolled patients admitted to our hospital for AHF from April 2012 to May 2016. Patients were divided into 3 groups based on the CONUT score at admission: normal (0-1), mild malnutrition (2-4) and moderate-severe malnutrition (5-12) groups. Baseline information was obtained and recorded within 24 hours after admission. All patients were followed up every 3 months by outpatient visit or telephone call until March 2019. The primary endpoint was all-cause mortality. The Kaplan-Meier survival curves and log-rank test were used to compare all-cause mortality between groups. Variables showing statistical significance in the univariate analysis were incorporated into multivariate Cox regression model to analyze the independent risk factors for all-cause mortality after discharge. Results: A total of 396 patients were enrolled in this study, including 114 patients with normal nutritional status, 200 patients with mild malnutrition and 82 patients with moderate-severe malnutrition. One hundred and fifty-eight patients died during a median follow-up of 34 (18, 46) months. The mortality was 32.4% (37/114), 39% (78/200) and 52.4% (43/82) in normal, mild malnutrition and moderate-severe malnutrition groups, respectively. The mortality was significantly higher in the moderate-severe malnutrition group than in normal nutrition group (P<0.05). However, there was no significant difference in mortality between normal and mild malnutrition group as well as between mild and moderate-severe malnutrition group (both P>0.05). Kaplan-Meier curves indicated that patients with high CONUT score group was at higher risk of all-cause mortality compared with those with low CONUT score (P=0.002). Cox proportional hazard analyses showed that the risk of all-cause mortality of moderate-severe malnutrition group was significantly higher than that of normal nutrition group (HR =1.648, 95%CI 1.021-2.660, P=0.041). Conclusions: The CONUT score of patients with AHF at admission is associated with the long-term prognosis. High CONUT score is an independent risk factor for all-cause mortality in AHF patients after discharge.
