Bonilla Palomas Juan Luis, Gámez López Antonio Luis, Moreno Conde Mirian, López Ibáñez María Cristina, Castellano García Patricia, Ráez Ruiz Carlos Javier, Ruíz Quirós Rocío, Ramiro Ortega Esmeralda
Hospital San Juan de la Cruz.
Nutr Hosp. 2017 Nov 14;34(5):1382-1389. doi: 10.20960/nh.1131.
Undernutrition is common among acute heart failure patients and its prognosis impact has been established. The prognosis role of undernutrition among chronic heart failure patients is not known. Objetive:The aim of this study were to evaluate the influence of nutritional status on long-term mortality in patients with chronic hear failure.
304 consecutively patients attended in our Heart failure Unit from November 2011 to November 2016 were prospectively analysed. A global nutritional assessment was performed and the states of undernutrition and at risk of malnutrition were assessment by the Mini Nutritional Assessment test. Their possible independent association with mortality was analyzed by Cox multivariate analysis.
The mean age was 74.6 ± 10.1 years, 41.1% were female and the most frequent aetiology was ischemic heart disease (39.1%). 11.5% of the patients were classified as undernourished and 38.2% were classified as at risk of malnutrition. The remaining 50.3% were classified by the MNA as adequate nutritional status. After 28 months (median of follow-up), mortality was 68.9%, 33.3% and 15.2%, respectively (Log-rank, p < 0.001). When Cox multivariate analysis was performed, the state of undernutrition was an independent predictor of mortality (Hazard ratio 2.73; 95% confidence interval, 1.55-4.81; p < 0.001).
The prevalence of undernutrition and risk of malnutrition reaches high levels in chronic heart failure patients. Moreover, the state of undernutrition by Mini Nutritional Assessment score is an independent predictor of mortality in these patients.
营养不良在急性心力衰竭患者中很常见，并且其对预后的影响已经明确。营养不良在慢性心力衰竭患者中的预后作用尚不清楚。目的：本研究旨在评估营养状况对慢性心力衰竭患者长期死亡率的影响。
对2011年11月至2016年11月在我们心力衰竭科连续就诊的304例患者进行前瞻性分析。进行全面的营养评估，并通过微型营养评定法评估营养不良和营养不良风险状态。通过Cox多变量分析分析它们与死亡率的可能独立关联。
平均年龄为74.6±10.1岁，女性占41.1%，最常见的病因是缺血性心脏病（39.1%）。11.5%的患者被归类为营养不良，38.2%的患者被归类为有营养不良风险。其余50.3%的患者经微型营养评定法评定为营养状况良好。28个月（随访中位数）后，死亡率分别为68.9%、33.3%和15.2%（对数秩检验，p<0.001）。进行Cox多变量分析时，营养不良状态是死亡率的独立预测因素（风险比2.73；95%置信区间，1.55 - 4.81；p<0.001）。
慢性心力衰竭患者中营养不良和营养不良风险的发生率很高。此外, 根据微型营养评定法评分得出的营养不良状态是这些患者死亡率的独立预测因素。
