Research Center for Traditional Medicine and History of Medicine, Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Shiraz University of Medical Sciences, Shiraz, Iran.
ESC Heart Fail. 2024 Apr;11(2):719-726. doi: 10.1002/ehf2.14612. Epub 2023 Dec 14.
Heart failure (HF) is a major public health challenge. Malnutrition has a significant effect on HF prognosis. Understanding the impact of social and clinical factors on the risk of malnutrition is necessary because it may aid in improving the health status of HF patients.
Three hundred twenty patients with HF who were hospitalized in a heart centre in Shiraz, Iran, from March to November 2022 were studied. Two validated questionnaires were used to evaluate malnutrition and social support: (1) Mini-Nutritional Assessment Short Form and (2) Medical Outcomes Study Social Support Survey. The participants were then divided into three groups: those with normal nutritional status (scores 12-14), those at risk of malnutrition (scores 7-11), and those who were malnourished (scores 0-6). The potential correlates of malnutrition (including socio-demographic, clinical, comorbidities, and laboratory factors) were included in the study. Then, ordinal logistic regression was used to investigate the correlates of malnutrition. The mean age of the participants was 64.2 ± 11.2 years, and more than half were male and married. Normal nutritional status was seen in 110 (34.4%) participants, 151 (47.2%) were at risk of malnutrition, and 58 (18.1%) were malnourished. The mean social support score of the participants was 61.65 ± 12.91. According to the adjusted odds ratios (95% confidence intervals) obtained from multivariate analysis, increased risk of malnutrition was associated with having a lower social support score [0.95 (0.93-0.97), P-value ≤ 0.001], lower body mass index [0.91 (0.86-0.97), P-value = 0.004], higher New York Heart Association classification [1.26 (1.02-1.56), P-value = 0.03], longer duration of disease [1.006 (1.001-1.01), P-value = 0.006], and lower serum albumin level [0.25 (0.08-0.75), P-value = 0.01].
Besides the clinical conditions affecting the risk of malnutrition in patients with HF, social support may play an important role. Including this factor in HF guidelines and developing educational programmes may help improve HF patients' health.
心力衰竭（HF）是一个重大的公共卫生挑战。营养不良对 HF 预后有重大影响。了解社会和临床因素对营养不良风险的影响是必要的，因为这可能有助于改善 HF 患者的健康状况。
2022 年 3 月至 11 月，对伊朗设拉子心脏中心住院的 320 名 HF 患者进行了研究。使用两种经过验证的问卷评估营养不良和社会支持：（1）Mini-Nutritional Assessment Short Form 和（2）Medical Outcomes Study Social Support Survey。然后，将参与者分为三组：营养状况正常（评分 12-14）、有营养不良风险（评分 7-11）和营养不良（评分 0-6）。研究包括营养不良的潜在相关因素（包括社会人口统计学、临床、合并症和实验室因素）。然后，使用有序逻辑回归分析营养不良的相关因素。参与者的平均年龄为 64.2±11.2 岁，超过一半为男性和已婚。110 名（34.4%）参与者营养状况正常，151 名（47.2%）有营养不良风险，58 名（18.1%）营养不良。参与者的平均社会支持得分为 61.65±12.91。根据多变量分析得出的调整后比值比（95%置信区间），社会支持评分较低与营养不良风险增加相关[0.95（0.93-0.97），P 值≤0.001]、较低的体重指数[0.91（0.86-0.97），P 值=0.004]、较高的纽约心脏协会分级[1.26（1.02-1.56），P 值=0.03]、疾病持续时间较长[1.006（1.001-1.01），P 值=0.006]和较低的血清白蛋白水平[0.25（0.08-0.75），P 值=0.01]。
除了影响 HF 患者营养不良风险的临床状况外，社会支持可能发挥重要作用。在 HF 指南中纳入这一因素并制定教育计划可能有助于改善 HF 患者的健康状况。
