The associations between atrial fibrillation and parameters of nutritional status assessment in the general hospital population — a cross-sectional analysis of medical documentation

Abstract

A b s t r a c tBackground: Atrial fibrillation (AF) and nutrition status abnormalities are two of the most significant epidemics in current health care. Aim:The aim of this study was to determine the relationship between the prevalence and outcome of AF, and the parameters of nutritional status among consecutive, real-life patients hospitalised in a university hospital. Methods:Analysis of the medical documentation of 4930 consecutive patients aged ≥ 18 years hospitalised for more than one day with diagnoses of cardiovascular disorders. Results:Patients admitted with a diagnosis of AF (n = 512) compared to their counterparts without AF less frequently had an NRS-2002 score ≥ 3, normal range of body mass index (BMI), higher blood haemoglobin, and lower low density lipoprotein cholesterol (LDL-C) concentration. In logistic regression analysis, the risk of a hospitalisation due to AF was negatively related to BMI, NRS-2002 score, and the value of the difference between ideal and actual body mass. Urgent admission and having an NRS--2002 score ≥ 3 remained the only significant variables determining the risk of in-hospital death. Blood concentration of LDL-C and urgent admission were the only significant variables determining risk of 30-day rehospitalisation in the studied population. Conclusions:Inpatients with AF had a lower prevalence of normal body mass. Patients with an AF diagnosis had different risk factors for in-hospital death and 30-day rehospitalisation than their counterparts with diagnosis of cardiovascular diseases but without AF; however, the parameters of nutritional status played an important role in both patient groups. The obesity and cholesterol paradoxes were also observed.

Relation between parameters of body composition and echocardiography in patients with nonvalvular atrial fibrillation

“…The links between obesity and the risk of AF and other cardiovascular conditions found in our study have been evidenced previously [1,2,17]. The evidence for the associations mentioned is strengthened through a reported favorable effect of weight reduction on the risk of AF occurrence [8,9].…”

“…The lack of statistically significant relationships between parameters of adipose tissue distribution and the values of the echocardiographic parameters indexed to BSA might suggest that cardiac ultrasound morphology in our patients depended not on the patients' nutritional status, but on body size or individual, non-nutritional factors determining morphological and/or electrical cardiac remodelling. This hypothesis might run counter to, for example, evidenced data linking obesity with the risk of AF [1,2]. Therefore, we performed analysis Table 3.…”

“…Disturbances in nutritional status and atrial fibrillation (AF) are significant current health problems. Obesity is one of the evidenced risk factors for AF [1,2], although diabetes mellitus, hypertension, obstructive sleep apnea, enlargement of the left atrium, and cardiac failure also influence the risk of atrial arrhythmia [3,4]. However, the importance of undernutrition as a risk factor for AF is understudied due to the exclusion of patients with a body mass index (BMI) < 18.5 kg/m 2 from the majority of studies on associations between patients' nutritional status and the risk of various cardiovascular conditions [1].…”

The association between nutritional and functional status in patients undergoing endovascular intervention due to chronic lower limbs ischemia

“…Therefore, the course of the right arm of the U-shaped curve draws more attention, as it concerns patients with a better prognosis. Many studies indicate that it is shifted to the right side, far beyond the BMI WHO's ranges regarded as correct ones [1][2][3][4][5][6][7][8][9]. This effect is often referred to as the "obesity paradox" and consists in a better prognosis of overweight patients and mildly obese patients as compared to patients with normal body weight and with similar severity of atherosclerosis of the lower limbs [10].…”

“…The nutritional status of patients and the risk associated with the nutritional status are assessed on the basis of: (a) a nutritional history, sometimes generated in the form of validated questionnaires (NRS-2002; Subjective Global Assessment, SGA;, Malnutrition Universal Screening Tool, MUST; Mini-Nutritional Assessment, MNA) [4]; (b) physical examination including anthropometric measurements (height, weight, BMI, abdominal circumference, arm circumference, thickness of skin folds); (c) body composition analysis (bioelectric impedance, BIA, dual energy x-ray absorptiometry, DXA, computed tomography, CT, magnetic resonance, MR); (d) biochemical markers of malnutrition (albumin, cholesterol, hemoglobin, transferrin and leptin concentration albumin, absolute lymphocyte count in blood); and (e) complex clinical and biochemical indicators of nutrition, mainly based on history, measurements of current and ideal body weight, and results of biochemical tests (e.g. nutritional risk index NRI; geriatric nutritional index, GNRI; instant nutritional assessment, INA; Prognostic Nutritional Index, PNI; prognostic inflammation and nutritional index, PINI; Onodera's (Preoperative) Prognostic Nutritional Index, OPNI [4]. An important and recently appreciated indicator for assessment of the patient's nutritional status is the determination of the amount of muscle tissue, or more precisely its deficiency, called sarcopenia [11][12][13][14][15].…”