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

Abstract

BACKGROUND\nLittle 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.\n\n\nMATERIAL AND METHODS\nWe 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)\u202f<\u202f12 points. Unadjusted and adjusted logistic regression models were used to assess the association between risk of malnutrition and 30-day mortality.\n\n\nRESULTS\nWe 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\u202f=\u202f3.4; 95%CI 1.2-9.7; p\u202f=\u202f.020 and adjusted OR by model 2\u202f=\u202f3.1; 95%CI 1.1-9.0; p\u202f=\u202f.033) compared to normal nutritional status.\n\n\nCONCLUSIONS\nThe 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.