TY - JOUR
T1 - Mini nutritional assessment is a better predictor of mortality than subjective global assessment in heart failure out-patients
AU - Joaquín, Clara
AU - Puig, Rocío
AU - Gastelurrutia, Paloma
AU - Lupón, Josep
AU - de Antonio, Marta
AU - Domingo, Mar
AU - Moliner, Pedro
AU - Zamora, Elisabet
AU - Martin, Mariona
AU - Alonso, Núria
AU - Puig-Domingo, Manel
AU - Bayes-Genis, Antoni
N1 - Funding Information:
This work was supported by grants from Generalitat de Catalunya (SGR 2014, CERCA Programme and PERIS Programme, Departament de Salut SLT002/16/00209), Red de Terapia Celular – TerCel (RD16/0011/0006), and CIBER Cardiovascular (CB16/11/00403), as part of the Plan Nacional de I + D + I, and it was cofunded by ISCIII-Sudirección General de Evaluación , the Fondo Europeo de Desarrollo Regional , and the “La Caixa” Banking Foundation . This work as developed within the AdvanceCat project, with the support of ACCIÓ (Catalonia Trade & Investment; Generalitat de Catalunya), under the Catalonian European Regional Development Fund (ERDF) operational program, 2014–2020.
Publisher Copyright:
© 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/12
Y1 - 2019/12
N2 - Background & aims: There is no consensus on the best method for nutritional screening and assessment in patients with heart failure (HF). This study aimed to determine which nutritional assessment method had the highest prognostic significance for patients with HF treated in outpatient clinics. We also aimed to identify a fast, reliable screening method for detecting malnutrition in these patients. Methods: This prospective study included 151 subjects that attended an outpatient HF clinic at a university hospital. All patients completed three nutritional screening tools: the Malnutrition Universal Screening Tool (MUST), the MNA-short form (MNA-SF), and the Malnutrition Screening Tool (MST), and then, two nutritional assessment questionnaires: the Subjective Global Assessment (SGA) and the Mini Nutritional Assessment®(MNA). Patients were followed-up for 2 years. The primary endpoint was all-cause mortality. Results: Malnutrition or nutritional risk was identified in 15.9% of patients with the SGA and in 25.1% of patients with the MNA. Age, New York Heart Association (NYHA) functional class, and MNA were the only independent all-cause death predictors after adjusting for age, gender, NYHA functional class, body mass index, Barthel index, 25-hydroxyvitamin D concentrations, treatment with angiotensin converting enzyme inhibitors or angiotensin II receptor blockers, and treatment with beta-blockers. The SGA could not independently predict all-cause mortality in a multivariate analysis that included the same covariates. The MNA-SF had the best sensitivity, specificity, and kappa coefficient for screening malnutrition, based on the MNA and the SGA as references, compared to the other screening methods. Conclusions: In our cohort, malnutrition assessed by MNA, but not by SGA, was an independent predictor of mortality. MNA-SF showed remarkable sensitivity and specificity; thus, it might be a valuable tool for rapidly identifying malnutrition risk in outpatients with HF.
AB - Background & aims: There is no consensus on the best method for nutritional screening and assessment in patients with heart failure (HF). This study aimed to determine which nutritional assessment method had the highest prognostic significance for patients with HF treated in outpatient clinics. We also aimed to identify a fast, reliable screening method for detecting malnutrition in these patients. Methods: This prospective study included 151 subjects that attended an outpatient HF clinic at a university hospital. All patients completed three nutritional screening tools: the Malnutrition Universal Screening Tool (MUST), the MNA-short form (MNA-SF), and the Malnutrition Screening Tool (MST), and then, two nutritional assessment questionnaires: the Subjective Global Assessment (SGA) and the Mini Nutritional Assessment®(MNA). Patients were followed-up for 2 years. The primary endpoint was all-cause mortality. Results: Malnutrition or nutritional risk was identified in 15.9% of patients with the SGA and in 25.1% of patients with the MNA. Age, New York Heart Association (NYHA) functional class, and MNA were the only independent all-cause death predictors after adjusting for age, gender, NYHA functional class, body mass index, Barthel index, 25-hydroxyvitamin D concentrations, treatment with angiotensin converting enzyme inhibitors or angiotensin II receptor blockers, and treatment with beta-blockers. The SGA could not independently predict all-cause mortality in a multivariate analysis that included the same covariates. The MNA-SF had the best sensitivity, specificity, and kappa coefficient for screening malnutrition, based on the MNA and the SGA as references, compared to the other screening methods. Conclusions: In our cohort, malnutrition assessed by MNA, but not by SGA, was an independent predictor of mortality. MNA-SF showed remarkable sensitivity and specificity; thus, it might be a valuable tool for rapidly identifying malnutrition risk in outpatients with HF.
KW - Heart failure
KW - MNA
KW - Nutritional screening
KW - Vitamin D
UR - http://www.scopus.com/inward/record.url?scp=85059456779&partnerID=8YFLogxK
U2 - 10.1016/j.clnu.2018.12.001
DO - 10.1016/j.clnu.2018.12.001
M3 - Artículo
C2 - 30616882
AN - SCOPUS:85059456779
VL - 38
SP - 2740
EP - 2746
JO - Clinical Nutrition
JF - Clinical Nutrition
SN - 0261-5614
IS - 6
ER -
