Prediction of all-cause mortality with malnutrition assessed by nutritional screening and assessment tools in patients with heart failure：a systematic review |
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| Affiliation: | 1. School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, NO.9 Dong Dan San Tiao, 100730, Beijing, China;2. Heart Failure Care Unit, Heart Failure Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100045, Beijing, China;1. Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China;2. Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, PR China;1. Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University, Wuxi, Jiangsu, 214122, China;2. Wuxi Municipal Center for Disease Control and Prevention, Wuxi, Jiangsu, 214023, China;3. Institutes of Biology and Medical Sciences, Soochow University, Suzhou, Jiangsu, 215000, China;1. Division of General Internal Medicine and Health Services Research, University of California, 1100 Glendon Avenue, Suite 850, Los Angeles, CA 90024, USA;2. Departments of Neurology and Epidemiology, University of Washington, 908 Jefferson St, Seattle, WA 98104, USA;1. Department of Molecular Medicine and Medical Biotechnology, Federico II University, Naples, Italy;2. Department of Clinical Medicine and Surgery University Federico II Naples, Italy;3. Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Italy;1. First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece;2. Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands;3. Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands;4. First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, Athens, Greece;5. Ottery & Associates, LLC. Deerfield (Greater Chicago Area), IL, USA;1. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;2. China National Clinical Research Center for Neurological Diseases, Beijing, China;3. Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China;4. Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, 2019RU018, Beijing, China;5. Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China |
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| Abstract: | Background and aimsIn the absence of a gold standard or scientific consensus regarding the nutritional evaluation of heart failure (HF) patients, this study aimed to summarize and systematically evaluate the prognostic value of nutritional screening and assessment tools used for all-cause mortality in HF patients.Methods and resultsRelevant studies were retrieved from major databases (PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang Data, and China Biology Medicine disc (CMB)) and searched from the earliest available date until July 2021. If three or more studies used the same tool, meta-analysis using RevMan 5.3 was performed. This systematic review was registered at PROSPERO (number CRD42021275575). A total of 36 articles involving 25,141 HF patients were included for qualitative analysis and 31 studies for quantitative analysis. Meta-analysis of these studies indicated, poor nutritional status evaluated by using 5 nutritional screening tools (Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI), Controlling Nutritional Status Score (CONUT), Nutritional Risk Index (NRI), and Short Form Mini Nutritional Assessment (MNA-SF)) or 2 nutritional assessment tools (the Mini Nutritional Assessment (MNA) and Generated Subjective Global Assessment (SGA)) predicted all-cause mortality in HF patients. Of all tools analyzed, MNA had the maximum HR for mortality HR = 2.62, 95%CI 1.11–6.20, P = 0.03] and MNA-SF HR = 1.94, 95%CI 1.40–2.70, P＜0.001] was the best nutritional screening tools.ConclusionPoor nutritional status predicted all-cause mortality in HF patients. MNA may be the best nutritional assessment tool, and MNA-SF is most recommended for HF patient nutritional screening. The application value of MNA, especially in patients with reduced left ventricular ejection fraction (LVEF), needs to be further confirmed. The clinical application value of Mini-Nutrition Assessment Special for Heart Failure (MNA-HF) and Global Leadership Initiative on Malnutrition (GLIM) in HF patients needs to be confirmed. |
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| Keywords: | Nutritional screening Nutritional assessment All-cause mortality Heart faliure |
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