10.3389/fpsyg.2012.00132

Vollständiger Abstract

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<h4>Background</h4>Heart failure is a common cardiovascular disease among older adults. Combined with frailty, it may aggravate the patient's condition and affect the prognosis. Nutritional status is important in older patients, but its relationship to frailty associated with heart failure is not fully understood.<h4>Methods</h4>This single-center retrospective study initially screened 236 older patients with heart failure who were admitted to Yuncheng Central Hospital in Yuncheng, Shanxi Province, China, between March 2020 and February 2023. After 36 patients were excluded according to the predefined eligibility criteria, 200 patients were included in the final analysis. A two-stage grouping strategy was used. First, all included patients underwent frailty assessment: patients without frailty were assigned to the control group, whereas those with frailty were assigned to the experimental group. Prognostic outcomes were compared between these two primary groups. Second, only patients in the experimental group underwent nutritional assessment and were further divided into the normal nutrition, mild malnutrition, and moderate-to-severe malnutrition subgroups. Appropriate parametric or nonparametric tests were used for comparisons between the frailty and non-frailty groups and among the three nutritional-status subgroups. A multivariable Cox proportional hazards regression model was used to evaluate factors associated with adverse prognosis.<h4>Results</h4>A total of 200 older patients with heart failure were included. Among them, 92 patients with frailty were assigned to the experimental group, whereas 108 patients without frailty were assigned to the control group. During the 6-month follow-up, mortality was higher in the experimental group than in the control group [4/92 (4.35%) vs. 1/108 (0.93%)], as was the readmission rate [13/92 (14.13%) vs. 2/108 (1.85%)] (both <i>P</i> < 0.05). Within the experimental group, 19 patients (20.65%) were classified into the normal nutrition subgroup, 31 (33.70%) into the mild malnutrition subgroup, and 42 (45.65%) into the moderate-to-severe malnutrition subgroup. Adverse outcomes occurred in 1/19 patients (5.26%), 5/31 patients (16.13%), and 11/42 patients (26.19%), respectively, with the incidence increasing as nutritional status worsened (<i>P</i> < 0.05). Serum albumin (ALB) and prealbumin (PAB) levels, Geriatric Nutritional Risk Index (GNRI) scores, and the proportion of patients with high-density lipoprotein (HDL) ≥ 0.8 mmol/L were lower in the two malnutrition subgroups than in the normal nutrition subgroup. These indicators were also lower in the moderate-to-severe malnutrition subgroup than in the mild malnutrition subgroup (all <i>P</i> < 0.05). Multivariable Cox proportional hazards regression analysis showed that GNRI and HDL were associated with adverse prognosis (both <i>P</i> < 0.05).<h4>Conclusion</h4>Frailty in older patients with heart failure is detrimental to the prognosis, and nutritional status is closely related to the prognosis of frailty in older patients with heart failure, which may lead to prolonged hospitalization, increased rehospitalization rates, and an increased risk of death. Therefore, clinical practice should pay attention to the assessment of patients' nutritional status and take corresponding measures to intervene to improve the patient's prognosis.

Abstract: PubMed · Datensatz