Nutritional Intervention in Malnourished Hospitalized Patients with Heart Failure

Background and Aims Hospitalized patients with heart failure who are malnourished present a worse prognosis than those with an adequate nutritional status. We undertook this study to assess whether a nutritional intervention in malnourished hospitalized patients with heart failure benefits morbidity...

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Published in:Archives of medical research 2016-10, Vol.47 (7), p.535-540
Main Authors: Bonilla-Palomas, Juan L, Gámez-López, Antonio L, Castillo-Domínguez, Juan C, Moreno-Conde, Mirian, López Ibáñez, María C, Alhambra Expósito, Rosa, Ramiro Ortega, Esmeralda, Anguita-Sánchez, Manuel P, Villar-Ráez, Antonia
Format: Article
Language:English
Subjects:
Acute Disease
Aged
Aged, 80 and over
Clinical trial
Female
Heart failure
Heart Failure - physiopathology
Heart Failure - therapy
Humans
Inpatients
Internal Medicine
Male
Malnutrition
Malnutrition - diet therapy
Malnutrition - physiopathology
Mortality
Nutritional intervention
Nutritional Status
Outcomes
Patient Readmission
Risk
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Summary:Background and Aims Hospitalized patients with heart failure who are malnourished present a worse prognosis than those with an adequate nutritional status. We undertook this study to assess whether a nutritional intervention in malnourished hospitalized patients with heart failure benefits morbidity and mortality. Methods A multicenter, randomized, controlled clinical trial was conducted. A total of 120 malnourished hospitalized patients due to acute heart failure were randomised to conventional heart failure treatment or conventional heart failure treatment combined with an individualized nutritional intervention. The primary endpoint of this study was a composite of all-cause death or readmission for worsening of HF, with a maximum follow-up of 12 months. Analysis was by intention to treat. Results Recruitment was stopped early according to the study protocol after completing the follow-up of the first 120 patients enrolled (59 in the intervention group and 61 in the control group). Both groups were homogeneous in baseline characteristics. At 12 months, the primary outcome occurred in 27.1% of patients in the intervention group and in 60.7% of patients in the control group (hazard ratio 0.45; 95% confidence interval [CI], 0.19–0.62, p  = 0.0004). In total, 20.3% of patients died in the intervention group and 47.5% in the control group (hazard ratio 0.37, 95% CI, 0.19–0.72, p  = 0.003). Readmission due to heart failure was also lower in the intervention group (10.2 vs. 36.1%, p  = 0.001). Conclusion Nutritional intervention in malnourished hospitalized patients with heart failure reduces the risk of death from any cause and the risk of readmission for worsening of heart failure ( ClinicalTrial.gov NCT01472237 ).
ISSN:0188-4409
1873-5487
DOI:10.1016/j.arcmed.2016.11.005