Background
Malnutrition is common in patients with heart failure (HF) but is often neglected,
despite guidelines suggesting that all hospitalised patients should undergo nutritional
screening within 24-hours of admission.
Aims
This study investigated the nutritional screening rates and determined the immediate
and long-term clinical outcomes in patients with HF admitted at two tertiary hospitals
in Australia.
Methods
Nutritional screening was assessed by the Malnutrition Universal Screening Tool (MUST)
completion rates. Patients were classified into two categories based on their MUST
scores (0=low malnutrition risk and ≥1=at risk of malnutrition). Propensity-score-matching
(PSM) was used to match 20 variables depending upon the risk of malnutrition. Clinical
outcomes included the days-alive-and-out-of-hospital at 90 days of discharge (DAOH90),
length of hospital stay, in-hospital, 30-day and 180-day mortality and 30-day readmissions.
Results
There were 5,734 HF admissions between 2013–2020, of whom, only 789 (13.8%) patients
underwent MUST screening. The mean (SD) age was 76.2 (14.0) years and 51.9% were males.
Five-hundred and fifty-four (554) (70.2%) patients were at low malnutrition risk and
235 (29.8%) at risk of malnutrition. In HF patients, who were at risk of malnutrition,
the DAOH90 were lower by 5.9 days (95% CI -11.49 to -0.42, p=0.035) and 180-day mortality
was significantly worse (coefficient 0.10, 95% CI 0.02–0.18, p=0.007) compared to
those who were at low risk of malnutrition. However, other clinical outcomes were
similar between the two groups.
Conclusion
Nutrition screening is poor in hospitalised HF patients and long-term but not short-term
clinical outcomes were worse in malnourished HF patients.
Keywords
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Article info
Publication history
Published online: November 22, 2022
Accepted:
October 2,
2022
Received in revised form:
September 19,
2022
Received:
May 10,
2022
Identification
Copyright
© 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
