Department of Rehabilitation, Yodogawa Christian Hospital, Osaka, Japan.
Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome Suma, Kobe, 654-0142, Japan.
Heart Vessels. 2022 Oct;37(10):1740-1748. doi: 10.1007/s00380-022-02077-0. Epub 2022 May 5.
The relationship between low physical function (LPF) at discharge and food intake percentage (FIP) during hospitalization is unclear. We aimed to clarify the relationship between LPF at discharge and FIP and the change in nutritional status during hospitalization in elderly patients with heart failure (HF), and determine cutoff values for FIP and change in nutritional status during hospitalization. We included 431 consecutive patients aged ≥ 65 years who were hospitalized for HF and underwent cardiac rehabilitation (CR) from 2017 to 2019. Physical function at discharge was classified into two groups according to the Short Performance Physical Battery (SPPB): low physical function (LPF) (SPPB ≤ 9) and high physical function (HPF) (SPPB > 9). We compared background, clinical parameters, pre-hospital walking level, CR progress, nutritional factors during hospitalization including FIP of the main dish and side dish, and changes in nutritional status using the Geriatric Nutritional Risk Index (ΔGNRI) at admission and discharge. Multiple logistic regression analysis was also performed. The final analysis included 213 patients (age, 81.6 years) divided into the LPF (n = 136) and HPF groups (n = 77). The LPF group showed low FIP and a high ΔGNRI value. Multivariate analysis showed FIP main dish, ΔGNRI, worsening renal function, pre-hospital walking level, and days to start of walking to be factors influencing LPF at discharge. Respective cutoff values for FIP main dish and ΔGNRI predicting LPF at discharge were 82.2% and 4.24. FIP main dish during hospitalization and ΔGNRI were associated with LPF at discharge.
出院时低身体机能(LPF)与住院期间食物摄入量百分比(FIP)之间的关系尚不清楚。我们旨在阐明老年心力衰竭(HF)患者出院时 LPF 与 FIP 之间的关系以及住院期间营养状况的变化,并确定 FIP 和住院期间营养状况变化的截断值。我们纳入了 2017 年至 2019 年因 HF 住院并接受心脏康复(CR)的 431 例连续≥65 岁的患者。根据简短表现身体电池(SPPB)将出院时的身体机能分为两组:低身体机能(LPF)(SPPB≤9)和高身体机能(HPF)(SPPB>9)。我们比较了背景、临床参数、院前步行水平、CR 进展、住院期间的营养因素,包括主菜和副菜的 FIP,以及入院和出院时使用老年营养风险指数(ΔGNRI)的营养状况变化。还进行了多变量逻辑回归分析。最终分析包括 213 例患者(年龄 81.6 岁),分为 LPF 组(n=136)和 HPF 组(n=77)。LPF 组的 FIP 主菜和 ΔGNRI 值较低。多变量分析显示,FIP 主菜、ΔGNRI、肾功能恶化、院前步行水平和开始步行的天数是影响出院时 LPF 的因素。预测出院时 LPF 的 FIP 主菜和 ΔGNRI 的各自截断值分别为 82.2%和 4.24。住院期间的 FIP 主菜和 ΔGNRI 与出院时的 LPF 相关。