Tevik Kjerstin, Thürmer Hanne, Husby Marit Inderhaug, de Soysa Ann Kristin, Helvik Anne-Sofie
Department of Cardiology, St. Olav's University Hospital, Postbox 3250 Sluppen, 7006 Trondheim, Norway; Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Postbox 8905, NO-7491 Trondheim, Norway; Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Postbox 2136, 3013 Tønsberg, Norway.
Telemark Hospital, Medical Department, Postbox 234, 3672 Notodden, Norway.
Clin Nutr ESPEN. 2016 Apr;12:e20-e29. doi: 10.1016/j.clnesp.2016.02.095. Epub 2016 Mar 13.
BACKGROUND & AIMS: Mortality among patients with chronic heart failure (CHF) is still high despite progress in medical and surgical treatment. The patients' nutritional condition may play an important role, and needs further investigation. The aim of this study was to evaluate whether nutritional risk in hospitalized patients with CHF was associated with three-year mortality.
A prospective study was conducted in 131 hospitalized Norwegian patients with CHF. Nutritional screening was performed using Nutritional Risk Screening (NRS-2002). The primary clinical outcome was death from any cause.
The prevalence of nutritional risk was 57% (NRS-2002 score ≥ 3). The overall mortality rate was 52.6% within three-year follow up. More patients at nutritional risk (N = 51) died compared to patients not at nutritional risk (N = 18) (P < 0.001). In adjusted analyses patients at nutritional risk had more than five-time higher odds (OR 5.85; 95% CI 2.10-16.24) to die before three-year follow-up than those not at nutritional risk. In adjusted Cox multivariate analysis, the nutritional risk was associated with increased mortality (HR 2.78; 95% CI 1.53-5.03). Furthermore, in adjusted analysis components in NRS-2002 were associated with mortality, i.e. nutritional status (HR 1.82; 95% CI 1.03-3.22), severity of disease (NYHA-class IV) (HR 1.78; 95% CI 1.00-3.16) and age (≥ 70 year) (HR 3.24; 95% CI 1.48-7.10).
Nutritional risk as defined by NRS-2002 in hospitalized patients with CHF was significantly associated with long term mortality.
尽管在内科及外科治疗方面取得了进展，但慢性心力衰竭（CHF）患者的死亡率仍然很高。患者的营养状况可能起着重要作用，需要进一步研究。本研究的目的是评估CHF住院患者的营养风险是否与三年死亡率相关。
对131例挪威CHF住院患者进行了一项前瞻性研究。使用营养风险筛查（NRS-2002）进行营养筛查。主要临床结局是任何原因导致的死亡。
营养风险患病率为57%（NRS-2002评分≥3）。在三年随访期间，总死亡率为52.6%。与无营养风险的患者（N = 18）相比，有营养风险的患者（N = 51）死亡更多（P < 0.001）。在调整分析中，有营养风险的患者在三年随访前死亡的几率比无营养风险的患者高出五倍多（OR 5.85；95% CI 2.10 - 16.24）。在调整后的Cox多变量分析中，营养风险与死亡率增加相关（HR 2.78；95% CI 1.53 - 5.03）。此外，在调整分析中，NRS-2002中的各项指标与死亡率相关，即营养状况（HR 1.82；95% CI 1.03 - 3.22）、疾病严重程度（纽约心脏协会IV级）（HR 1.78；95% CI 1.00 - 3.16）和年龄（≥70岁）（HR 3.24；95% CI 1.48 - 7.10）。
NRS-2002定义的CHF住院患者营养风险与长期死亡率显著相关。
