Title : Can malnutrition predict mortality in heart failure with low ejection fraction? Implications for multidisciplinary care
Abstract:
Objectives: This study aimed to investigate the prognostic value of malnutrition in predicting mortality among patients with heart failure and reduced ejection fraction, emphasizing the importance of a multidisciplinary care approach.
Methods: A total of 216 patients diagnosed with heart failure and low ejection fraction were included in this cross-sectional study. Nutritional status was assessed using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Participants were categorized into two groups: malnourished and non-malnourished. In addition, Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) scores were calculated. All patients were followed up via telephone or outpatient visits for one year, during which the frequency and duration of hospitalizations were documented.
Results: The mean age of the participants was 67.10 ± 5.59 years, with 106 females (49.1%). According to the GLIM criteria, 57 patients (26.4%) were classified as malnourished. High CONUT scores and severe malnutrition based on PNI were identified in 43 (19.9%) and 31 (14.4%) patients, respectively. Independent predictors of mortality included GLIM-defined malnutrition (B=1.385, p=0.007, OR=3.994, 95% CI=1.470–10.850), prolonged hospital stay (B=0.122, p<0.001, OR=1.130, 95% CI=1.058–1.206), and elevated neutrophil count (B=0.252, p=0.005, OR=1.287, 95% CI=1.081–1.532).
Conclusion: Malnutrition, as assessed by GLIM and CONUT tools, is prevalent among heart failure patients and serves as a significant predictor of increased mortality. The findings underscore the need for early detection and comprehensive interventions, including physiotherapy, to improve patient outcomes.
Keywords: Malnutrition, Heart Failure, Reduced Ejection Fraction, Mortality.
