Carretero Gómez J, Galeano Fernández T F, Vidal Ríos A S, Tolosa Álvarez S, Sánchez Herrera M, García Carrasco C, Monreal Periañez F J, González González P, Arévalo Lorido J C
Internal Medicine Department. University Hospital Complex of Badajoz, Badajoz, Spain.
Internal Medicine Department. University Hospital Complex of Badajoz, Badajoz, Spain.
Rev Clin Esp (Barc). 2025 Feb;225(2):92-100. doi: 10.1016/j.rceng.2024.11.005. Epub 2024 Nov 29.
This work aims to describe nutrition and sarcopenia in inpatients with heart failure (HF). It also aims to assess factors associated with in-hospital and short-term prognosis related to nutrition and sarcopenia.
We collected data on consecutive HF patients admitted to a single center's internal medicine ward. Patients were recruited in May and October 2021. Malnutrition was determined by the Mini Nutritional Assessment-Short Form (MNA-SF) and sarcopenia by the screening test, SARC-F scale, and handgrip strength test.
190 patients were analyzed, mean age 82.1 (±8.2), 54.2% women, median follow up 106 days. Patients were classified into three groups based on MNA-SF score: group 1 (12-14 points, no risk) included 50 patients, group 2 (8-12 points, high risk of malnutrition) included 81 patients, group 3 (0-7 points, malnourished) included 59 patients. Group 3 had significantly more inflammation (lower albumin and higher C-reactive Protein (CRP)) and congestion (measured by NT-ProBNP levels). In-hospital mortality was related to poor muscle function, CRP, and NT-ProBNP, but not to malnutrition. The poorest short-term outcomes were related to malnutrition and comorbidity. However, when the variable of muscle function was introduced, it could act as a poor prognostic factor related to CRP and NT-ProBNP, which were the main determinants of survival.
In malnourished patients with HF, inflammation and congestion were related to in-hospital mortality. Malnutrition along with comorbidity may play a role in decreasing short-term survival. Early identification through proactive nutritional and functional screenings should be a key element of assessing HF patients.
本研究旨在描述心力衰竭（HF）住院患者的营养状况和肌肉减少症。同时评估与营养和肌肉减少症相关的院内及短期预后因素。
我们收集了一家单一中心内科病房连续收治的HF患者的数据。患者于2021年5月和10月招募。营养不良通过微型营养评定简表（MNA-SF）确定，肌肉减少症通过筛查测试、SARC-F量表和握力测试确定。
共分析了190例患者，平均年龄82.1（±8.2）岁，女性占54.2%，中位随访时间106天。根据MNA-SF评分将患者分为三组：第1组（12 - 14分，表示无风险）包括50例患者，第2组（8 - 12分，表示营养不良高风险）包括81例患者，第3组（0 - 7分，表示营养不良）包括59例患者。第3组的炎症反应（白蛋白水平较低，C反应蛋白（CRP）水平较高）和充血（通过NT - proBNP水平测量）明显更严重。院内死亡率与肌肉功能差、CRP和NT - proBNP有关，但与营养不良无关。最差的短期结局与营养不良和合并症有关。然而，当引入肌肉功能变量时，它可能作为与CRP和NT - proBNP相关的不良预后因素，而CRP和NT - proBNP是生存的主要决定因素。
在营养不良的HF患者中，炎症和充血与院内死亡率有关。营养不良和合并症可能在降低短期生存率方面起作用。通过积极的营养和功能筛查进行早期识别应是评估HF患者的关键要素。
