Study on application of nutritional risk screening in hospitalized patients with chronic heart failure

doi:10.16150/j.1671-2870.2021.02.011

Abstract

Abstract:

Objectives: To assess the incidence of nutritional risk in hospitalized patients with chronic heart failure（CHF） using nutritional risk screening 2002 scale(NRS 2002) and analyze the relationship between CHF and NRS 2002. Methods: A prospective study was conducted in patients with CHF admitted at the Department of Cardiology. NRS 2002 was performed to assess nutritional risk of the patients. Nutrition related body mass index(BMI), hemoglobin, prealbumin, albumin, triglyceride, total cholesterol, renal function and CHF-related biomarker pro-brain-type natriuretic peptide (pro-BNP) were measured, and correlation of above mentioned indices with NRS 2002 was analyzed. All the patients were followed-up for six months, and readmission due to heart failure(HF) was counted. Results: A total of 165 patients were included in the study. When patients with NRS 2002 score ≥3 were regarded as having nutritional risk,the incidence of nutritional risk in the hospitalized patients with CHF was 50.3%. In patients with nutritional risk,patients aged 60 years and older accounted for 73.5%, higher than that in patients without(P<0.05). Compared with NRS 2002 score<3 group, percentage of patients with Ⅲor Ⅳcardiac function by New York Heart Association (NYHA) in NRS 2002 score≥3 group was significantly higher (P<0.05), while levels of BMI, albumin, prealbumin, hemoglobin, cholesterol and eGFR were lower (P<0.05). Spearman rank correlation test showed that NRS 2002 score was negatively correlated with BMI, pro-BNP, albumin, proalbumin, hemoglobin, triglyceride, cholesterol (P<0.05), while was positively correlated with age and NYHA grade (P<0.05). The NRS 2002 score, pro-BNP and albumin levels differed significantly between patients with different NYHA grades (P<0.05). However, there was no statistically significant difference in readmission rate between NRS 2002 score≥3 group and <3 group (P=0.496). Conclusions: The incidence of nutritional risk in hospitalized patients with CHF is as high as 50.3%.NRS 2002 is suitable for nutritional risk screening in patients with CHF during hospitalization,and can be used as part of the overall assessment of the patients.

Key words: Chronic heart failure, Nutritional risk screening 2002 scale, Nutritional risk

CLC Number:

R541.4

SHENG Hong, ZHANG Andi. Study on application of nutritional risk screening in hospitalized patients with chronic heart failure[J]. Journal of Diagnostics Concepts & Practice, 2021, 20(02): 178-183.

Figures/Tables 3

References 19

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参数	所有患者（n=165）	NRS 2002评分<3分组（n=82）	NRS 2002评分≥3分组（n=83）	P值
性别
男	103（62.4%）	54（65.9%）	49（59.0%）	0.313
女	62（37.6%）	28（34.1%）	34（41.0%）
平均年龄（岁）	62.1±14.5	57.6±12.7	66.5±15.0	<0.001
年龄<60岁	69（41.8%）	47（57.3%）	22（26.5%）
年龄≥60岁	96（58.2%）	35（42.7%）	61（73.5%）
NYHA心功能分级				<0.001
Ⅱ	67（40.6%）	42（51.2%）	25（30.1%）	<0.001
Ⅲ	75（45.4%）	31（37.8%）	44（53.0%）	<0.001
Ⅳ	23（14.0%）	9（10.0%）	14（16.9%）	<0.001
BMI（kg/m²）	24.8±5.5	26.5±5.1	23.4±5.4	<0.001
LVEF（%）	40.5±12.2	41.1±12.4	40.5±12.2	0.524
实验室检查
pro-BNP（ng/L）	2 465.4±2 681.4	2 356.3±3 142.5	2 759.6±2 311.2	0.161
白蛋白（g/L）	38.3±4.6	39.3±4.0	37.3±4.8	0.004
前白蛋白（mg/L）	226.5±220.9	262.9±297.0	193.4±65.5	0.035
C反应蛋白（mg/L）	9.7±27.3	6.3±2.1	12.7±33.6	0.163
血红蛋白（g/L）	132.8±21.4	138.4±19.2	126.1±22.3	<0.001
三酰甘油（mmol/L）	1.4±0.7	1.5±0.7	1.3±0.7	0.056
胆固醇（mmol/L）	3.9±1.1	4.2±1.1	3.6±1.0	0.000
血肌酐（μmol/L）	91.5±32.9	86.6±25.1	96.3±38.3	0.062
eGFR[mL/（min·1.73 m²]	76.1±24.1	81.7±20.5	70.5±23.7	0.003
再入院	24（14.5%）	11（13.4%）	13（15.7%）	0.496

项目	r值	P值
性别	0.057	0.473
年龄	0.359	<0.001
NYHA心功能分级	0.402	<0.001
BMI	-0.415	<0.001
白蛋白	-0.182	0.008
前白蛋白	-0.027	0.001
血红蛋白	-0.302	<0.001
三酰甘油	-0.253	0.003
胆固醇	-0.286	<0.001
LVEF	-0.089	0.262
eGFR	-0.276	<0.001

NYHA心功能分级	例数(n)	NRS 2002评分	BMI(kg/m²)	pro-BNP(pg/mL)	LVEF(%)	前白蛋白(mg/L)	白蛋白(g/L)	血红蛋白(g/L)
Ⅱ级	67	2.2±0.7	25.4±4.6	1 561.1±1 808.8	42.3±12.7	266.6±39.7	39.5±3.6	135.7±19.5
Ⅲ级	75	3.1±1.0^a)	24.4±6.3	3 145.8±3 183.3^a)	39.7±12.5	201.4±69.5	37.9±5.0^a)	131.7±21.6
Ⅳ级	23	3.2±1.1^a)	25.1±5.3	2 465.4±2 236.8^a)	38.6±8.9	180.2±56.3	35.8±4.9^a)	125.4±26.5
P值		<0.001	0.316	0.001	0.263	0.133	0.004	0.33