Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA.
Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
Nutrition. 2022 Jan;93:111495. doi: 10.1016/j.nut.2021.111495. Epub 2021 Sep 24.
This study assesses the effect of malnutrition on the in-hospital outcomes of patients with takotsubo cardiomyopathy (TCM).
We performed a retrospective cohort analysis using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes for a primary diagnosis of TCM from the National Inpatient Sample database (2016-2018). A concurrent diagnosis of malnutrition was then identified, and these patients were divided into the malnutrition group and non-malnutrition group. To adjust for underlying risk factors, a multivariable logistic regression model was employed followed by a propensity score matching analysis for the malnutrition and the non-malnutrition group. We then compared the in-hospital outcomes between these two groups.
Among 4733 patients with a primary diagnosis of TCM, 221 (4.7%) patients with TCM were found to be malnourished. After propensity score matching, patients with TCM with malnutrition were found to have a higher mortality rate (8.3% versus 2.0%, P < 0.001), a higher rate of complications including cardiogenic shock (16.1% versus 7.0%, P < 0.001), ventricular arrhythmia (8.8% versus 3.9%, P = 0.01), acute kidney injury (24.9% versus 10.6%, P < 0.001), and acute respiratory failure (32.7% versus 17.8%, P < 0.001). There was no statistically significant difference in the incidence of cardiac arrest between the two groups. Malnutrition of severe degree was associated with a sevenfold (odds ratio 6.8, 95% confidence interval, 3.2-13.4) increased risk of in-hospital mortality compared with those without malnutrition.
Patients with malnutrition who were admitted with TCM were associated with higher rates of in-hospital mortality and complications compared with those without malnutrition.
本研究评估营养不良对 Takotsubo 心肌病（TCM）患者住院结局的影响。
我们使用国际疾病分类，第十次修订版，临床修正（ICD-10-CM）代码，从国家住院患者样本数据库（2016-2018 年）中对 TCM 的主要诊断进行回顾性队列分析。然后确定营养不良的并发诊断，并将这些患者分为营养不良组和非营养不良组。为了调整潜在的危险因素，我们采用多变量逻辑回归模型，然后对营养不良组和非营养不良组进行倾向评分匹配分析。然后比较这两组患者的住院结局。
在 4733 例 TCM 主要诊断患者中，发现 221 例（4.7%）TCM 患者存在营养不良。在进行倾向评分匹配后，发现营养不良的 TCM 患者死亡率更高（8.3% vs. 2.0%，P < 0.001），并发症发生率更高，包括心源性休克（16.1% vs. 7.0%，P < 0.001）、室性心律失常（8.8% vs. 3.9%，P = 0.01）、急性肾损伤（24.9% vs. 10.6%，P < 0.001）和急性呼吸衰竭（32.7% vs. 17.8%，P < 0.001）。两组之间心脏骤停的发生率无统计学差异。严重程度营养不良与住院期间死亡的风险增加七倍（优势比 6.8，95%置信区间，3.2-13.4）相关，与无营养不良者相比。
患有 TCM 并伴有营养不良的患者与无营养不良者相比，住院期间死亡率和并发症发生率更高。
