Influencia de la desnutrición sobre la mortalidad a largo plazo en pacientes ambulatorios con insuficiencia cardiaca crónica

Juan Luis Bonilla Palomas, Antonio Luis Gámez López, Mirian Moreno Conde, María Cristina López Ibáñez, Patricia Castellano García, Carlos Javier Ráez Ruiz, Rocío Ruíz Quirós, Esmeralda Ramiro Ortega


Background: Undernutrition is common among acute heart failure patients and its prognosis impact has been established. The prognosis role of undernutrition among chronic heart failure patients is not known.

Objetive:The aim of this study were to evaluate the influence of nutritional status on long-term mortality in patients with chronic hear failure.

Methods: 304 consecutively patients attended in our Heart failure Unit from November 2011 to November 2016 were prospectively analysed. A global nutritional assessment was performed and the states of undernutrition and at risk of malnutrition were assessment by the Mini Nutritional Assessment test. Their possible independent association with mortality was analyzed by Cox multivariate analysis.

Results: The mean age was 74.6 ± 10.1 years, 41.1% were female and the most frequent aetiology was ischemic heart disease (39.1%). 11.5% of the patients were classified as undernourished and 38.2% were classified as at risk of malnutrition. The remaining 50.3% were classified by the MNA as adequate nutritional status. After 28 months (median of follow-up), mortality was 68.9%, 33.3% and 15.2%, respectively (Log-rank, p < 0.001). When Cox multivariate analysis was performed, the state of undernutrition was an independent predictor of mortality (Hazard ratio 2.73; 95% confidence interval, 1.55-4.81; p < 0.001).

Conclusions: The prevalence of undernutrition and risk of malnutrition reaches high levels in chronic heart failure patients. Moreover, the state of undernutrition by Mini Nutritional Assessment score is an independent predictor of mortality in these patients.

Palabras clave

Insuficiencia cardiaca; Desnutrición; Mini Nutritional Assessment; Mortalidad.

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