GLIM-based malnutrition, protein intake and diet quality in preprocedural Transcatheter Aortic Valve Implantation (TAVI) patients.

Abstract

Diagnosed prevalence of malnutrition and dietary intake are currently unknown in patients with severe aortic stenosis planned to undergo Transcatheter Aortic Valve Implantation (TAVI). This study describes the preprocedural nutritional status, protein intake and diet quality. Consecutive preprocedural TAVI patients were asked to participate in this explorative study. Nutritional status was diagnosed with the global leadership initiative on malnutrition (GLIM) criteria. Preprocedural protein intake and diet quality were assessed with a three-day dietary record. To increase the record's validity, a researcher visited the participants at their homes to confirm the record. Protein intake was reported as an average intake of three days and diet quality was assessed using the Dutch dietary guidelines (score range 0-14, 1 point for adherence to each guideline). Of the included patients (n=50, median age 80±5, 56% male) 32% (n=16) were diagnosed with malnutrition. Patients diagnosed with malnutrition had a lower protein intake (1.02±0.28g/kg/day vs 0.87±0.21g/kg/day, p=0.04). The difference in protein intake mainly took place during lunch (20±13g/kg vs 13±7g/kg, p=0.03). Patients adhered to 6.4±2.2 out of 14 dietary guidelines. Adherence to the guideline of whole grains and ratio of whole grains was lower in the group of patients with malnutrition than in patients with normal nutritional status (both 62% vs 19%, p=0.01). In a multivariate analysis diabetes mellitus was found as an independent predictor of malnutrition. Prevalence of malnutrition among TAVI patients is very high up to 32%. Patients with malnutrition had lower protein and whole grain intake than patients with normal nutritional status. Furthermore, we found diabetes mellitus as independent predictor of malnutrition. Nutrition interventions in this older patient group are highly warranted.