急性心力衰竭患者的医院膳食摄入量及其与长期预后的关联。
Hospital meal intake in acute heart failure patients and its association with long-term outcomes.
作者信息
Yoshida Taizo, Shoji Satoshi, Shiraishi Yasuyuki, Kawana Masataka, Kohno Takashi, Inoue Kenji, Fukuda Keiichi, Heidenreich Paul A, Kohsaka Shun
机构信息
Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
Department of Medicine, Division of Cardiovascular Medicine, Stanford University, Stanford, California, USA.
出版信息
Open Heart. 2020 May;7(1). doi: 10.1136/openhrt-2020-001248.
BACKGROUND
Risk prediction for hospitalised heart failure (HF, HHF) patients remains suboptimal. We aimed to determine the prognostic value of hospital food intake (FI) immediately before discharge among HHF patients.
METHOD
We analysed the data of 255 HHF patients extracted from the records of a single university hospital. The FI percentage of the three meals the day before hospital discharge was averaged. Patients were stratified into adequate FI (100% consumption) and inadequate FI (less than 100% consumption) groups. The primary outcome was the composite of all-cause mortality and/or HF readmission within 1 year.
RESULTS
Only 49.3% of HHF patients consumed 100% of their meals. Patients with inadequate FI were older; predominantly women; and had a lower body mass index, higher brain natriuretic peptide levels and Clinical Frailty Scale scores at discharge than those with adequate FI. Inadequate FI was significantly associated with adverse outcomes after adjustments (HR 2.00; 95% CI 1.09 to 3.67; p=0.026). The effect of interaction by ejection fraction (EF) was highly significant: HF with preserved EF (≥40%) was significantly associated with inadequate FI with adverse outcomes (HR 4.95; 95% CI 1.71 to 14.36; p=0.003) but HF with reduced EF (<40%) was not (HR 0.77; 95% CI 0.31 to 1.95; p=0.590).
CONCLUSIONS
The hospital FI assessment might be a simple, useful tool for predicting and stratifying risk for HHF patients.
背景
住院心力衰竭（HF，HHF）患者的风险预测仍不尽人意。我们旨在确定HHF患者出院前即刻的医院食物摄入量（FI）的预后价值。
方法
我们分析了从一家大学医院记录中提取的255例HHF患者的数据。计算出院前一天三餐的FI百分比平均值。患者被分为充足FI（摄入量为100%）和不足FI（摄入量低于100%）组。主要结局是1年内全因死亡率和/或HF再入院的复合结局。
结果
只有49.3%的HHF患者三餐摄入量达到100%。FI不足的患者年龄更大；以女性为主；出院时体重指数更低、脑钠肽水平更高且临床衰弱量表评分更高。调整后，FI不足与不良结局显著相关（风险比2.00；95%置信区间1.09至3.67；p = 0.026）。射血分数（EF）的交互作用影响非常显著：射血分数保留的HF（≥40%）与FI不足及不良结局显著相关（风险比4.95；95%置信区间1.71至14.36；p = 0.003），但射血分数降低的HF（<40%）并非如此（风险比0.77；95%置信区间0.31至1.95；p = 0.590）。
结论
医院FI评估可能是预测HHF患者风险和进行风险分层的一种简单、有用的工具。
Zotero 插件