Andreae Christina, van der Wal Martje H L, van Veldhuisen Dirk J, Yang Bei, Strömberg Anna, Jaarsma Tiny
J Cardiovasc Nurs. 2021;36(6):539-545. doi: 10.1097/JCN.0000000000000756.
Decreased appetite can contribute to malnutrition in patients with heart failure (HF). Little is known about the trajectory of appetite over time in patients with HF and the factors associated with decreased appetite after discharge from the hospital.
The aims of this study were to investigate changes in appetite over time and explore how fatigue, depressive symptoms, and quality of life are associated with decreased appetite.
Data from the multicenter randomized Coordinating study evaluating Outcomes of Advising and Counseling in Heart Failure were used. Logistic regression and mixed-effects logistic regression were used to investigate changes in appetite over time and to explore the relationship between appetite and fatigue, depressive symptoms, and quality of life.
A total of 734 patients with HF (mean age, 69 years) were included. Decreased appetite was present at all follow-up measurements; however, decreased appetite was significantly lower at the 1-month (odds ratio [OR], 0.43; confidence interval [CI], 0.29-0.63), 6-month (OR, 0.31; CI, 0.20-0.47), 12-month (OR, 0.22; CI, 0.14-0.34), and 18-month (OR, 0.24; CI, 0.15-0.37) follow-ups compared with baseline. Decreased appetite was associated with fatigue (OR, 3.09; CI, 1.98-4.84), depressive symptoms (OR, 1.76; CI, 1.35-2.29), and low quality of life (OR, 1.01; CI, 1.01-1.02) across all measurement points adjusted for covariates.
Appetite improved after discharge; however, at all time points, at least 22% of patients reported decreased appetite. Fatigue, depressive symptoms, and low quality of life are factors associated with decreased appetite. Decreased appetite is a long-standing problem in that it does not disappear spontaneously after an acute HF deterioration.
食欲下降会导致心力衰竭（HF）患者出现营养不良。对于HF患者食欲随时间的变化轨迹以及出院后食欲下降的相关因素，人们知之甚少。
本研究旨在调查食欲随时间的变化，并探讨疲劳、抑郁症状和生活质量与食欲下降之间的关联。
使用了多中心随机协调研究“心力衰竭咨询与辅导结果评估”的数据。采用逻辑回归和混合效应逻辑回归来研究食欲随时间的变化，并探讨食欲与疲劳、抑郁症状和生活质量之间的关系。
共纳入734例HF患者（平均年龄69岁）。在所有随访测量中均存在食欲下降的情况；然而，与基线相比，在1个月（优势比[OR]，0.43；置信区间[CI]，0.29 - 0.63）、6个月（OR，0.31；CI，0.20 - 0.47）、12个月（OR，0.22；CI，0.14 - 0.34）和18个月（OR，0.24；CI，0.15 - 0.37）随访时，食欲下降的情况显著减轻。在对协变量进行调整后的所有测量点上，食欲下降与疲劳（OR，3.09；CI，1.98 - 4.84）、抑郁症状（OR，1.76；CI，1.35 - 2.29）和生活质量低下（OR，1.01；CI，1.01 - 1.02）相关。
出院后食欲有所改善；然而，在所有时间点，至少22%的患者报告食欲下降。疲劳、抑郁症状和生活质量低下是与食欲下降相关的因素。食欲下降是一个长期存在的问题，因为在急性HF病情恶化后它不会自行消失。
