What is the optimal nutritional assessment tool for predicting decline in the activity of daily living among older patients with heart failure?
What is the optimal nutritional assessment tool for predicting decline in the activity of daily living among older patients with heart failure?
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DOI：
10.1007/s00380-022-02033-y
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发表时间：
2022-02-05
影响因子：
1.5
通讯作者：
Yamada, Minoru
中科院分区：
文献类型：
--
作者：
Kojima, Iwao;Tanaka, Shu;Yamada, Minoru
营养管理在老年心力衰竭住院患者日常生活活动中的临床重要性日益增加。我们确定了最佳的营养评估工具，可以预测老年住院HF患者的ADL下降。我们前瞻性研究了91例年龄≥ 65岁的急性心力衰竭住院患者。我们测量他们的营养状况在入院时使用营养指标：控制营养状况（CONUT），老年营养风险指数，预后营养指数，和迷你营养评估。采用Logistic回归分析，在单因素和多因素分析中估计各营养指标类别评估的营养不良状况与Barthel指数（BI）测量的ADL下降之间关系的比值比（OR）和95%置信区间（CI）。在参与者中，28.6%（n = 26;中位年龄81.5岁; 69.2%男性）的参与者被纳入降低BI组，71.4%（n = 65;中位年龄79.0岁; 67.7%男性）的参与者被纳入维持BI组。降低BI组的CONUT值显著高于维持BI组，但其他营养指标无显著差异。在多变量logistic回归分析中，较高的CONUT评分与BI降低的风险显著升高相关（校正OR 0.24; 95%CI 0.08-0.75; p = 0.014）。我们发现，CONUT是一个适当的营养评估工具，用于预测老年住院HF患者在住院早期的ADL下降。
The clinical importance of nutritional management in activities of daily living (ADL) among older inpatients with heart failure (HF) is greatly increasing. We determined the optimal nutritional assessment tool that can predict ADL decline among older inpatients with HF. We prospectively investigated 91 inpatients aged >= 65 years with HF in an acute hospital. We measured their nutritional status at admission using nutrition indices: the controlling nutritional status (CONUT), the geriatric nutritional risk index, the prognostic nutritional index, and the mini nutritional assessment. Logistic regression analysis was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the relationships between the malnutrition status assessed by each nutritional index category and the ADL decline measured by the Barthel index (BI) in the univariate and multivariate analyses. Among the participants, 28.6% (n = 26; median age 81.5 years; 69.2% men) of the participants were included in the Reduced BI group and 71.4% (n = 65; median age 79.0 years; 67.7% men) in the Maintained BI group. The Reduced BI group showed a significantly higher CONUT value than the Maintained BI group, but there were no significant differences in other nutritional indices. In the multivariate logistic regression analysis, a higher CONUT score was associated with a significantly elevated risk of Reduced BI (adjusted OR 0.24; 95%CI 0.08-0.75; p = 0.014). We found that CONUT is an appropriate nutritional assessment tool for predicting ADL decline among older inpatients with HF in the early phase of hospitalization.