Study On The Correlation Between Controlling Nutritional Status Score And Prognosis In Elderly Patients With Acute Heart Failure

ObjectivesThe purpose of this study was to explore the prognostic value of controlling nutritional status(CONUT)score in elderly patients with acute heart failure.MethodsThe study was a retrospective,observational,single-center study.According to2014 China guidelines for the diagnosis and treatment of HF,we enrolled a total of224 elderly patients(Age≥60 years)-hospitalized for acute heart failure from May2016 to May 2019.Patients were divided into three groups: normal:(CONUT 0-1,n=66),mild malnutrition:(CONUT 2-4,n=110)and moderate-severe malnutrition(CONUT>4,n=17).The primary outcome during follow-up was all cause mortality.We use software SPSS 23.0 to analyze the basic data.ResultsA total of 224 subjects with an average age of 78±9 years were enrolled in this study,including 127 males(56.7%).The mean CONUT was 2.91±2.2.Sperman correlation analysis showed that CONUT was positively correlated with age,log NT-pro BNP,but negatively correlated with body mass index,hemoglobin,triglyceride,high density lipoprotein,low density lipoprotein and estimated glomerular filtration rate(P<0.05).During the median follow-up period of 545 days days,36 patients died.These subjects had lower body mass index,heart rate,diastolic pressure,lymphocyte,hemoglobin,total protein,albumin,total cholesterol,estimated glomerular filtration rate,Otherwise,they had higher CONUT score and log NT-Pro BNP(P<0.05).Multivariate Cox regression analysis showed that malnutrition assessed by CONUT score was an independent risk factor for mortality in elderly patients with acute heart failure(P<0.05).Meanwhile,moderate to severe malnutrition was an independent risk factor for mortality in elderly patients with heart failure [moderate to severe malnutrition vs normal nutritional,HR 5.830,95%CI(1.287-26.402),P=0.022<0.05].The Kaplan-Meier survival curve showed that the mortality of malnourished patients was significantly higher than that of non-malnourished patients.ConclusionsMalnutrition is independently associated with long-term survival in elderly patients hospitalised with AHF.CONUT can be simple,objective and effective to evaluate the nutritional status.Patients with heart failure who improve the nutritional status early and combine with routine treatment of heart failure can reduce the mortality further.