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

      Highlights

      • The frequency of risk of malnutrition is high in seniors with acute heart failure.
      • The risk of malnutrition is associated with 30-day mortality.
      • The routine screening may help emergency physicians in establishing a care plan.

      Abstract

      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.

      Keywords

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