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

Martín‐Sánchez, Francisco Javier; Triana, Federico Miguel Cuesta; Rosselló, Xavier; García, Rebeca Pardo; García, Guillermo; Caimari, Francisca; Vidán, María Teresa; Ruiz-Artacho, Pedro; Castillo, Juan González del; Llorens, Pere; Herrero, Pablo; Jacob, Javier; Gil, Víctor; Fernández-Pérez, Cristina; Gil, Pedro; Bueno, Héctor; Miró, Òscar; Martı́n, Pilar; Adrada, Esther Rodríguez; Santos, Maria Carmen Lopes Ferreira Silva; Salgado, Lucía; Brizzi, Berenice Nayla; Docavo, María Luisa; Suárez-Cadenas, María Del Mar; Xipell, Carolina; Sánchez, Carolina; Aguiló, Sira; Gaytán, Josep María; Jerez, Alba Rivas; Pérez‐Durá, María José; Gil, Pablo Berrocal; López‐Grima, María Luisa; Valero, Amparo; Aguirre, Alfons; Pedragosa, María Àngels; Piñera, Pascual; LázaroAragues, Paula; Nicolás, José Andrés Sánchez; Rizzi, Miguel Alberto; Herrera, Sergio; Alquézar, Aitor; Roset, Álex; Ferrer, Carles; Llopis, Ferrán; Pérez, José María Álvarez; Díez, María Pilar López; Richard, Fernando; Fernández‐Cañadas, José María; Carratalá, José Manuel; Javaloyes, Patricia; Andueza, Juan Antonio; Fernández, J.A. Sevillano; Romero, Rodolfo; Loranca, Marta Merlo; Rodríguez, Virginia Álvarez; Lorca, María Teresa; Calderón, Luis; Ferrer, Ester Soy; Garrido, José Manuel; Mojarro, Enrique Martín

doi:10.1016/j.ejim.2019.04.014

Cited by 29 publications

(22 citation statements)

References 35 publications

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“…Among the 761 screened citations, 28 studies published over the last 10 years 8,20,24,35–59 met the inclusion criteria after full-text review (Figure 1). These 28 studies included 19 different risk models that had been used in AHF patients in the ED setting to predict clinical outcomes (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…20,35,39,54–59,62 In addition, nine studies used at least one risk score to define the severity of AHF decompensation, to produce subgroups of patients based on their risk or to adjust in multivariate regressions (to reduce the impact of confounding factors). 8,24,36,45–50 In one of them, the comparison between discharged and hospitalised patients at similar predicted risk (using the risk model developed by Lee et al.) 24 demonstrated a higher 90-day mortality for patients discharged home from the ED.…”

Section: Resultsmentioning

confidence: 99%

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Risk stratification scores for patients with acute heart failure in the Emergency Department: A systematic review

Miró

Rosselló

Platz

et al. 2020

European Heart Journal. Acute Cardiovascular Care

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Aims This study aimed to systematically identify and summarise all risk scores evaluated in the emergency department setting to stratify acute heart failure patients. Methods and results A systematic review of PubMed and Web of Science was conducted including all multicentre studies reporting the use of risk predictive models in emergency department acute heart failure patients. Exclusion criteria were: (a) non-original articles; (b) prognostic models without predictive purposes; and (c) risk models without consecutive patient inclusion or exclusively tested in patients admitted to a hospital ward. We identified 28 studies reporting findings on 19 scores: 13 were originally derived in the emergency department (eight exclusively using acute heart failure patients), and six in emergency department and hospitalised patients. The outcome most frequently predicted was 30-day mortality. The performance of the scores tended to be higher for outcomes occurring closer to the index acute heart failure event. The eight scores developed using acute heart failure patients only in the emergency department contained between 4–13 predictors (age, oxygen saturation and creatinine/urea included in six scores). Five scores (Emergency Heart Failure Mortality Risk Grade, Emergency Heart Failure Mortality Risk Grade 30 Day mortality ST depression, Epidemiology of Acute Heart Failure in Emergency department 3 Day, Acute Heart Failure Risk Score, and Multiple Estimation of risk based on Emergency department Spanish Score In patients with Acute Heart Failure) have been externally validated in the same country, and two (Emergency Heart Failure Mortality Risk Grade and Multiple Estimation of risk based on Emergency department Spanish Score In patients with Acute Heart Failure) further internationally validated. The c-statistic for Emergency Heart Failure Mortality Risk Grade to predict seven-day mortality was between 0.74–0.81 and for Multiple Estimation of risk based on Emergency department Spanish Score In patients with Acute Heart Failure to predict 30-day mortality was 0.80–0.84. Conclusions There are several scales for risk stratification of emergency department acute heart failure patients. Two of them are accurate, have been adequately validated and may be useful in clinical decision-making in the emergency department i.e. about whether to admit or discharge.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Risk stratification scores for patients with acute heart failure in the Emergency Department: A systematic review

Miró

Rosselló

Platz

et al. 2020

European Heart Journal. Acute Cardiovascular Care

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“…As a consequence, HF patients develop an increasingly poor nutritional status. The association between nutritional status and 30-day mortality among elderly patients with acute HF has also been proven in the emergency department [37]. These findings suggest that the risk of malnutrition should be screened in older patients with acute HF in every context in order to plan the best strategy for each patient.…”

Section: Why Assess Malnutritionmentioning

confidence: 79%

Tools for the Assessment of the Malnutrition Status and Possible Interventions in Elderly with Cardiovascular Diseases

Tonet

Campana

Caglioni

et al. 2021

JCM

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Malnutrition represents a common and important feature in elderly people affected by cardiovascular diseases. Several studies have investigated its prevalence and prognostic role in most clinical settings, including cardiovascular disease. However, in daily practice it usually remains unrecognized and consequently untreated. The present review was ideated to answer the main questions about nutritional status assessment in patients with cardiovascular disease: why, when, where, how to evaluate it, and what to do to improve it. The three main cardiovascular diseases, namely aortic stenosis, ischaemic heart disease, and heart failure were considered. First, the main evidence supporting the prognostic role of malnutrition are summarized and analyzed. Second, the main tools for the assessment of malnutrition in the hospital and outpatient setting are reported for each condition. Finally, the possible strategies and interventions to address malnutrition are discussed.

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“…Os estudiosos Dent et al (2017) fizeram associação significativa entre desnutrição e depressão (p = 0,008) em idosos hospitalizados, devido ao grande impacto no apetite, e apontam que poucos estudos investigaram essa associação em ambiente hospitalar. Um recente estudo espanhol multicêntrico, utilizando a MNA®-SF em uma amostra de 749 idosos, encontrou também associação com risco nutricional e demência em idosos de um departamento de emergência cardíaca (MARTÍN SÁNCHEZ et al, 2019) No presente estudo, não foi encontrada associação significativa entre desnutrição e o fato de morar sozinho, ter baixa renda ou tipo de moradia (zona urbana ou rural). Comparando os achados com a literatura, ao contrário do que se espera, Alzahrani e Alamri (2017) apontaram que 92,4% dos idosos desnutridos e 59,7% dos sob risco de desnutrição moravam com mais pessoas (p = 0,001).…”

Section: Resultsunclassified

Perfil nutricional e socioeconômico de idosos admitidos no pronto atendimento médico de um hospital universitário

Gomes

Cônsolo

Sanches

2021

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A população mundial passa por processo de envelhecimento, sendo o idoso mais susceptível a alterações do estado nutricional, devendo ser sempre avaliado para que haja intervenção precoce. Objetivou-se traçar o perfil nutricional e socioeconômico de idosos admitidos no pronto atendimento médico de um hospital universitário. Trata-se de estudo transversal, prospectivo, amostra por conveniência, realizado nas primeiras 48 horas de internação nas áreas verde, amarela e vermelha do Sistema Único de Saúde. Foram avaliados 100 idosos de ambos os sexos, por meio de formulário socioeconômico, triagem MNA®-SF e avaliação nutricional. Observou-se uma maioria desnutrida ou sob risco nutricional, com prevalência masculina e forte relação com perda de peso, diminuição da ingesta, estresse ou doença aguda. Assim, constatou-se maior sensibilidade da MNA®-SF na identificação precoce do risco nutricional mesmo nos pacientes eutróficos ou em sobrepeso pelo IMC. Sugerem-se mais estudos associando transtornos neuropsicológicos em idosos e sua influência no estado nutricional na hospitalização.

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

Cited by 29 publications

References 35 publications

Risk stratification scores for patients with acute heart failure in the Emergency Department: A systematic review

Risk stratification scores for patients with acute heart failure in the Emergency Department: A systematic review

Tools for the Assessment of the Malnutrition Status and Possible Interventions in Elderly with Cardiovascular Diseases

Perfil nutricional e socioeconômico de idosos admitidos no pronto atendimento médico de um hospital universitário

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