Kwaśny Adrian, Łokieć Katarzyna, Uchmanowicz Bartosz, Młynarska Agnieszka, Smereka Jacek, Czapla Michał
Institute of Dietetics, Academy of Business Administration and Health Sciences, Lodz, Poland.
Department of Propaedeutic of Civilization Diseases, Medical University of Lodz, Lodz, Poland.
Nutr Metab Cardiovasc Dis. 2023 Nov;33(11):2242-2250. doi: 10.1016/j.numecd.2023.06.010. Epub 2023 Jun 19.
In patients with some cardiovascular disease conditions the result of Nutritional Risk Screening 2002 (NRS-2002) and body mass index (BMI) is related to the in-hospital mortality. The aim of this study was to assess the prognostic impact of BMI and NRS 2002 on in-hospital mortality among patients with acute myocardial infarction (AMI) in relation to sex.
The study was based on a retrospective analysis of 945 medical records of AMI patients admitted to the Cardiology Department between 2017 and 2019. Patients with a score NRS2002 ≥ 3 are considered to be nutritionally at risk. The WHO BMI criteria were used. The endpoint was in-hospital mortality. Logistic regression was used to analyse the impact of quantitative variables on dichotomous outcome. Odds ratios (OR) with 95% confidence intervals were reported. Female patients were significantly older than male patients (73.24 ± 11.81 vs 67 ± 11.81). In an unadjusted model, the risk of malnutrition was a significant predictor of the odds of in-hospital mortality only in female patients (OR = 7.51, p = 0.001). In a multivariate model adjusted by all variables, heart failure (HF) (OR = 8.408, p = 0.003) and the risk of malnutrition (OR = 6.555, p = 0.007) were independent predictors of the odds of in-hospital mortality in female patients. The only significant independent predictor of the odds of in-hospital mortality in male patients was HF (OR = 3.789 p = 0.006).
Only in the case of female patients with AMI, the risk of malnutrition was independently associated with the odds of in-hospital mortality. There was no effect of BMI on in-hospital mortality in both sexes.
在一些心血管疾病患者中，2002年营养风险筛查（NRS - 2002）结果和体重指数（BMI）与住院死亡率相关。本研究旨在评估BMI和NRS 2002对急性心肌梗死（AMI）患者住院死亡率的预后影响，并分析其与性别的关系。
本研究基于对2017年至2019年间心内科收治的945例AMI患者病历的回顾性分析。NRS2002评分≥3分的患者被认为存在营养风险。采用世界卫生组织的BMI标准。终点为住院死亡率。采用逻辑回归分析定量变量对二分结局的影响。报告比值比（OR）及95%置信区间。女性患者显著比男性患者年龄大（73.24±11.81岁 vs 67±11.81岁）。在未调整模型中，营养不良风险仅在女性患者中是住院死亡率比值的显著预测因素（OR = 7.51，p = 0.001）。在对所有变量进行调整的多变量模型中，心力衰竭（HF）（OR = 8.408，p = 0.003）和营养不良风险（OR = 6.555，p = 0.007）是女性患者住院死亡率比值的独立预测因素。男性患者住院死亡率比值的唯一显著独立预测因素是HF（OR = 3.789，p = 0.006）。
仅在AMI女性患者中，营养不良风险与住院死亡率比值独立相关。BMI对两性的住院死亡率均无影响。
