Nutritional screening based on the controlling nutritional status (CONUT) score at the time of admission is useful for long-term prognostic prediction in patients with heart failure requiring hospitalization

• DOI: 10.1007/s00380-017-1001-8
• Publication Date: 2017-05-31T23:12:04Z
• Authors: Isao Nishi; Yoshihiro Seo; Yoshie Hamada-Har...; Kimi Sato; Seika Sai; Masayoshi Yamamoto; Tomoko Ishizu; Akinori Sugano; Kenichi Obara; Longmei Wu; Shoji Suzuki; Akira Koike; Kazutaka Aonuma
• Keywords: Heart Failure; Male; 2. Zero hunger; Time Factors; Nutritional Status; Kaplan-Meier Estimate; Prognosis; 3. Good health; Hospitalization; Survival Rate; 03 medical and health sciences; Nutrition Assessment; 0302 clinical medicine; Risk Factors; Cause of Death; Humans; Female; Aged

The objective of the study was to clarify whether controlling nutritional status (CONUT) is useful for predicting the long-term prognosis of patients hospitalized with heart failure (HF). A total of 482 (57.5%) HF patients from the Ibaraki Cardiovascular Assessment Study-HF (N = 838) were enrolled (298 men, 71.7 ± 13.6 years). At admission, blood samples were collected and nutritional status assessed using CONUT. CONUT scores were defined as follows: 0-1, normal; 2-4, light; 5-8, moderate; and 9-12, severe undernutrition. Accordingly, 352 (73%) patients had light-to-severe nutritional disturbances. In the follow-up period [median 541.5 (range 354-786) days], 109 deaths were observed. A Kaplan-Meier analysis revealed that all-cause deaths occurred more frequently in HF patients with nutritional disturbances [n = 93 (26.4%)] than in those with normal nutrition [n = 16 (12.3%); log-rank p < 0.001]. The Cox proportional hazard analyses revealed that a per point increase in the CONUT score was associated with an increased risk of all-cause death (hazard ratio 1.142; 95% confidence interval, 1.044-1.249) after controlling simultaneously for age, sex, previous history of HF hospitalization, log brain natriuretic peptide, and use of therapeutic agents at admission (tolvaptan and aldosterone antagonists). This study suggests that nutritional screening using CONUT scores is helpful in predicting the long-term prognosis of patients hospitalized with HF in a multicenter registry setting.