Insufficient Calorie Intake Worsens Post-Discharge Quality of Life and Increases Readmission Burden in Heart Failure.
Insufficient Calorie Intake Worsens Post-Discharge Quality of Life and Increases Readmission Burden in Heart Failure.
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DOI：
10.1016/j.jchf.2020.04.004
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发表时间：
2020-09
影响因子：
13
通讯作者：
Hummel, Scott L.
中科院分区：
文献类型：
--
作者：
Bilgen, Feriha;Chen, Peiyu;Poggi, Armella;Wells, Joanna;Trumble, Erika;Helmke, Stephen;Teruya, Sergio;Catalan, Tonimarie;Rosenblum, Hannah R.;Cornellier, Maria L.;Karmally, Wahida;Maurer, Mathew S.;Hummel, Scott L.
评估心力衰竭（HF）住院患者热量摄入与出院后结局之间的关系。
营养不良会增加心力衰竭的不良结局，而饮食限钠可能会无意中恶化营养摄入。
在一项饮食干预试验中，通过布洛克食物频率问卷（FFQ）估算心力衰竭住院患者的基线营养摄入，并计算营养风险指数（NRI）。热量摄入不足定义为低于代谢需求的90%，并创建了一个15分的微量营养素缺乏评分。采用调整后的线性回归、逻辑回归和负二项回归来评估热量摄入不足与生活质量（堪萨斯城心肌病问卷临床总结[KCCQ - CS]）、再入院风险以及12周内再住院天数之间的关联。
在57名参与者（年龄70±8岁，31%为女性，体重指数32±8 kg/m²）中，钠和热量摄入的中位数分别为2987（四分位距2160 - 3540）mg/天和1602（四分位距1201 - 2142）kcal/天；11%的患者通过NRI筛查为营养不良。所有每日钠摄入量<2000 mg的患者都存在热量摄入不足；这组患者也更频繁地出现饮食微量营养素和蛋白质缺乏。在12周时，热量摄入不足的患者在KCCQ - CS方面的改善较小（β = -14.6，95%置信区间 -27.3 - -1.9），再入院几率更高（比值比14.5，95%置信区间2.2 - 94.4），再住院天数更多（发病率比31.3，95%置信区间4.3 - 229.3）。
尽管肥胖患病率高且明显营养不良罕见，但热量摄入不足与心力衰竭患者出院后生活质量较差以及再入院负担增加有关。住院患者的饮食评估可以改善再入院风险分层，并确定需要营养干预的患者。
Evaluate the relationship between calorie intake and post-discharge outcomes in hospitalized patients with heart failure (HF). Malnutrition increases adverse outcomes in HF, and dietary sodium restriction may inadvertently worsen nutritional intake. In a dietary intervention trial, baseline nutritional intake in HF inpatients was estimated via Block Food Frequency Questionnaire (FFQ) and a Nutritional Risk Index (NRI) was calculated. Insufficient calorie intake was defined at <90% of metabolic needs, and a 15-point micronutrient deficiency score was created. Adjusted linear, logistic, and negative binomial regression were used to evaluate associations between insufficient calorie intake and quality of life (Kansas City Cardiomyopathy Questionnaire Clinical Summary [KCCQ-CS]), readmission risk, and days rehospitalized over 12 weeks. Among 57 participants (age 70±8 years, 31% female, body mass index 32±8 kg/m2), median sodium and calorie intake were 2,987 (IQR 2,160–3,540) mg/day and 1,602 (IQR 1,2012,142) kcal/day; 11% of patients screened as malnourished by NRI. All patients consuming <2,000 mg/day sodium had insufficient calorie intake; this group also more frequently had dietary micronutrient and protein deficiencies. At 12 weeks, patients with insufficient calorie intake had less improvement in KCCQ-CS (β=−14.6, 95% CI −27.3_−1.9), higher readmission odds (OR 14.5, 95% CI 2.2–94.4), and more days rehospitalized (IRR 31.3, 95% CI 4.3–229.3). Despite high prevalence of obesity and rare overt malnutrition, insufficient calorie intake was associated with poorer post-discharge quality of life and increased readmission burden in patients with HF. Inpatient dietary assessment could improve readmission risk stratification and identify patients for nutritional intervention.
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影响因子：
24
作者：
Gorodeski EZ;Goyal P;Hummel SL;Krishnaswami A;Goodlin SJ;Hart LL;Forman DE;Wenger NK;Kirkpatrick JN;Alexander KP;Geriatric Cardiology Section Leadership Council, American College of Cardiology
通讯作者：
Geriatric Cardiology Section Leadership Council, American College of Cardiology
DOI：
10.1016/j.jchf.2015.08.007
发表时间：
2016-01
期刊：
JACC. Heart failure
影响因子：
--
作者：
Doukky R;Avery E;Mangla A;Collado FM;Ibrahim Z;Poulin MF;Richardson D;Powell LH
通讯作者：
Powell LH
影响因子：
37.8
作者：
Cobb, Laura K.;Anderson, Cheryl A. M.;Appel, Lawrence J.
通讯作者：
Appel, Lawrence J.
影响因子：
8.9
作者：
Adejumo, Oluwayemisi L.;Koelling, Todd M.;Hummel, Scott L.
通讯作者：
Hummel, Scott L.
影响因子：
5.7
作者：
Michalsen, A;König, G;Thimme, W
通讯作者：
Thimme, W