Abstract 15161: Impact of Malnutrition Score Index on Short-term Clinical Outcome in Patients with Acute Decompensated Heart Failure

Abstract

Backgrounds: Recent studies have elucidated the association between malnutrition and poor long-term prognosis in patients with chronic heart failure (HF), using controlling nutritional status (CONUT) score, a simple and useful index for evaluating malnutrition. In this study, we aim to investigate the prognostic significance of CONUT score in patients with acute decompensated HF. Methods: We examined 320 consecutive patients in our prospective acute decompensated HF registry database from January 2013 to January 2014. Patients with acute coronary syndrome, in-hospital death, and without complete data-set at discharge were excluded. Finally, we selected 206 patients as a study population and malnutrition was defined as CONUT score above 3 at discharge. Results: 112 (54%) patients showed malnutrition at discharge. Patients with malnutrition had higher age, serum creatinine and plasma brain natriuretic peptide levels, and lower serum sodium level at discharge than those without. There were no significant differences between the groups in terms of sex, blood pressure, heart rate, left ventricular ejection fraction, etiology of HF and cardiovascular medications at discharge. During the median follow-up of 192 days (interquartile range = 109-260 days), malnutrition was associated with higher short-term adverse events including death and HF admission (P = 0.008, Figure). Cox proportional-hazards model analysis demonstrated that malnutrition was independently associated with adverse events (HR 2.00, 95% CI 1.01-4.17, P = 0.047), even after adjustment among variables including age (HR 1.04, 95% CI 1.00-1.08, P = 0.03) and serum sodium level (HR 0.93, 95% CI 0.88-1.00, P = 0.04). Conclusions: In patients with acute decompensated HF, malnutrition at discharge was independently associated with worse short-term clinical outcomes. These findings suggest that earlier intensive nutrition management might need to be considered.