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Effect of risk of malnutrition on 30-day mortality among older patients with acute heart failure in Emergency Departments

Autores: Martin-Sanchez, F. J. (Autor de correspondencia); Triana, F. C.; Bossello, X. ; Garcia, R. P.; Garcia, G. L.; Caimari, F. ; Vidan, M. T.; Ruiz Artacho, Pedro Celso; del Castillo, J. G.; Llorens, P.; Herrero, P.; Jacob, J. ; Gil, V. ; Perez, C. F.; Gil, P.; Bueno, H.; Miro, O.; Martin, P. M. ; Adrada, E. R.; Santos, M. C.; Salgado, L.; Brizzi, B. N.; Docavo, M. L.; Suarez-Cadenas, M. D. ; Xipell, C.; Sanchez, C. ; Aguilo, S.; Gaytan, J. M.; Jerez, A.; Perez-Dura, M. J.; Gil, P. B.; Lopez-Grima, M. L.; Valero, A. ; Aguirre, A.; Pedragosa, M. A.; Pinera, P.; LazaroAragues, P. ; Nicolas, J. A. S.; Rizzi, M. A.; Mateo, S. H. ; Alquezar, A. ; Roset, A. ; Ferrer, C. ; Llopis, F. ; Perez, J. M. A.; Diez, M. P. L.; Richard, F.; Fernandez-Canadas, J. M.; Carratala, J. M.; Javaloyes, P.
ISSN: 0953-6205
Volumen: 65
Páginas: 69 - 77
Fecha de publicación: 2019
Background: Little is known about the prevalence and impact of risk of malnutrition on short-term mortality among seniors presenting with acute heart failure (AHF) in emergency setting. The objective was to determine the impact of risk of malnutrition on 30-day mortality risk among older patients who attended in Emergency Departments (EDs) for AHF. Material and methods: We performed a secondary analysis of the OAK-3 Registry including all consecutive patients >= 65 years attending in 16 Spanish EDs for AHF. Risk of malnutrition was defined by the Mini Nutritional Assessment Short Form (MNA-SF) < 12 points. Unadjusted and adjusted logistic regression models were used to assess the association between risk of malnutrition and 30-day mortality. Results: We included 749 patients (mean age: 85 (SD 6); 55.8% females). Risk of malnutrition was observed in 594 (79.3%) patients. The rate of 30-day mortality was 8.8%. After adjusting for MEESSI-AHF risk score clinical categories (model 1) and after adding all variables showing a significantly different distribution among groups (model 2), the risk of malnutrition was an independent factor associated with 30-day mortality (adjusted OR by model 1 = 3.4; 95% CI 1.2-9.7; p = .020 and adjusted OR by model 2 = 3.1; 95% CI 1.1-9.0; p = .033) compared to normal nutritional status. Conclusions: The risk of malnutrition assessed by the MNA-SF is associated with 30-day mortality in older patients with AHF who were attended in EDs. Routine screening of risk of malnutrition may help emergency physicians in decision-making and establishing a care plan.