Haruki Shintaro, Minami Yuichiro, Hattori Hidetoshi, Kametani Motoko, Im Jihaeng, Oyabu Kenjiro, Kishihara Makoto, Yamaguchi Junichi
Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Heart Vessels. 2025 Aug 12. doi: 10.1007/s00380-025-02595-7.
The modified nutrition risk in critically ill (mNUTRIC) score was developed to quantify the risk of adverse events related to malnutrition in the intensive care unit setting. However, its prognostic value has not been examined in patients with acute heart failure (AHF). This study aimed to investigate the relationship between mNUTRIC score and all-cause mortality in AHF patients in the cardiac intensive care unit (CCU). We retrospectively examined 307 patients with AHF who were admitted to our CCU from April 2014 to March 2017. mNUTRIC score was calculated within 24 h of CCU admission. Patients were classified as either high nutritional risk (score ≥ 5) or low nutritional risk (score < 5). The primary endpoint was death from any cause. Median follow-up was 272 days (interquartile range 59-588). Kaplan-Meier survival analysis showed that overall survival was significantly worse in the high nutritional risk group (p < 0.001). In the multivariate analysis adjusted for chronic kidney disease, systolic blood pressure, hypoalbuminemia, anemia, and C-reactive protein concentration, mNUTRIC score ≥ 5 was an independent predictor of higher all-cause mortality (adjusted hazard ratio, 2.23; 95% confidence interval, 1.33-3.72; p = 0.003). mNUTRIC score ≥ 5 at admission to the CCU is associated with increased risk of mortality in AHF patients in the CCU.
改良的危重症营养风险(mNUTRIC)评分旨在量化重症监护病房中与营养不良相关的不良事件风险。然而,其在急性心力衰竭(AHF)患者中的预后价值尚未得到研究。本研究旨在探讨mNUTRIC评分与心脏重症监护病房(CCU)中AHF患者全因死亡率之间的关系。我们回顾性研究了2014年4月至2017年3月期间入住我院CCU的307例AHF患者。mNUTRIC评分在CCU入院后24小时内计算。患者被分为高营养风险(评分≥5)或低营养风险(评分<5)。主要终点是任何原因导致的死亡。中位随访时间为272天(四分位间距59 - 588天)。Kaplan-Meier生存分析表明,高营养风险组的总体生存率显著更差(p<0.001)。在对慢性肾病、收缩压、低白蛋白血症、贫血和C反应蛋白浓度进行校正的多变量分析中,mNUTRIC评分≥5是全因死亡率较高的独立预测因素(校正风险比,2.23;95%置信区间,1.33 - 3.72;p = 0.003)。CCU入院时mNUTRIC评分≥5与CCU中AHF患者的死亡风险增加相关。