Risk factors associated with malnutrition in elderly patients with chronic heart failure.
Malnutrition affects 17.7% of elderly patients with chronic heart failure, with older age and lower body mass index being significant risk factors.
Where it sits
this study against the rest of the zenagamtide corpusSummary and findings
This study identified clinical determinants of malnutrition in elderly patients with chronic heart failure. A total of 203 patients were analyzed, with 36 (17.7%) classified as malnourished. Factors associated with malnutrition included older age, lower body mass index, and elevated inflammatory markers.
Abstract
This retrospective observational study aimed to identify clinical determinants of malnutrition in elderly patients with chronic heart failure. Elderly patients (≥65 years) with established chronic heart failure managed at a single tertiary hospital between January 2022 and December 2024 were included. Malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition criteria, using a 2-step approach combining risk screening and phenotypic and etiologic assessment. Demographic, anthropometric, comorbidity, laboratory, and heart failure-related data were extracted from electronic medical records. Univariate and multivariate logistic regression analyses were performed to explore factors associated with malnutrition, and model performance was evaluated using receiver operating characteristic analysis. Among 203 patients, 36 (17.7%) were classified as malnourished. Compared with non-malnourished patients, those with malnutrition were older and had a lower body mass index, lower serum albumin and prealbumin, higher C-reactive protein and neutrophil-to-lymphocyte ratio, poorer renal function, higher N-terminal pro-B-type natriuretic peptide levels, and a higher prevalence of New York Heart Association class III/IV and chronic obstructive pulmonary disease. In multivariate analysis, older age, lower body mass index, higher New York Heart Association class, elevated C-reactive protein, presence of chronic obstructive pulmonary disease, reduced estimated glomerular filtration rate, and higher N-terminal pro-B-type natriuretic peptide remained independently associated with malnutrition. The final model showed good discriminatory performance, with an area under the curve of 0.902, supporting its potential utility for nutritional risk stratification in this population.
Background
This paper addresses the prevalence and risk factors of malnutrition in elderly patients with chronic heart failure, a population known to be vulnerable to nutritional deficiencies. Prior studies have indicated that malnutrition can adversely affect outcomes in heart failure patients. Identifying specific risk factors is crucial for effective management and intervention strategies.
Methods
This retrospective observational study included elderly patients (≥65 years) with chronic heart failure managed at a single tertiary hospital from January 2022 to December 2024. A total of 203 patients were analyzed, and malnutrition was diagnosed using the Global Leadership Initiative on Malnutrition criteria. Univariate and multivariate logistic regression analyses were conducted to explore associations with malnutrition.
Results
Among the 203 patients, 36 (17.7%) were classified as malnourished. The final multivariate model identified older age, lower body mass index, higher New York Heart Association class, elevated C-reactive protein, presence of chronic obstructive pulmonary disease, reduced estimated glomerular filtration rate, and higher N-terminal pro-B-type natriuretic peptide as independently associated with malnutrition. The model demonstrated good discriminatory performance with an area under the curve of 0.902.
Interpretation
The findings suggest that several clinical factors are significantly associated with malnutrition in elderly heart failure patients. While the statistical significance of these associations is clear, the clinical relevance may vary, particularly given the multifactorial nature of malnutrition. Limitations such as the retrospective design and single-site nature of the study may affect the generalizability of the results.
Key findings
- 17.7% of patients classified as malnourished, n=203.
- Area under the curve of 0.902 for the final model.
- Lower body mass index and higher C-reactive protein were associated with malnutrition.
- Higher N-terminal pro-B-type natriuretic peptide levels were found in malnourished patients.
- Older age and reduced estimated glomerular filtration rate were independently associated with malnutrition.
Limitations
- retrospective observational design
- single-site data collection
- no causal relationships established
- potential for selection bias
- limited generalizability