Malnutrition predicts in-hospital death risk for women admitted for heart attack
Key takeaways:
- Malnutrition is a risk factor for in-hospital death among women with acute coronary syndrome.
- No such relationship was found for men.
Women admitted with ACS at risk for malnutrition had a more than sixfold higher odds for in-hospital mortality compared with women not at malnutrition risk, researchers reported.
There was no such relationship observed for men.
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“While previous research has looked at the impact of nutritional status on mortality in patients with ACS, little data is available showing differences based on sex and nutritional status,” Jacek Smereka, MD, PhD, DSc, MBA, associate professor in the department of emergency medical service at Wroclaw Medical University in Poland, and colleagues wrote in Nutrition, Metabolism and Cardiovascular Diseases. “Therefore, in this study we sought to assess the impact of nutritional status on in-hospital mortality in ACS patients in relation to sex. Increased risk of malnutrition is a significant factor affecting, among others, the length of hospital stay, risk of complications, risk of hospital readmission and risk of death in patients with CVD. This is also the case for patients with ACS. Poor nutrition, including malnutrition, is also a public health problem for economic reasons.”
In a retrospective study, Smereka and colleagues analyzed medical records data from 945 patients admitted with acute MI to the Institute of Heart Diseases at University Clinical Hospital in Wroclaw from 2017 to 2019. Researchers assessed nutritional status and severity of disease-related stress metabolism using the Nutritional Risk Screening 2002 (NRS-2002) tool. Those with a score of 3 or greater are considered nutritionally at risk. The primary outcome was in-hospital mortality. Within the cohort, women were older than men, with mean age of 73 and 67 years, respectively.
In an unadjusted model, risk for malnutrition was a predictor of in-hospital mortality for women only, with an OR of 7.51 (P = .001). In an adjusted model, HF (OR = 8.408; P = .003) and risk for malnutrition (OR = 6.555; P = .007) were independent predictors of in-hospital mortality for women. For men, only HF persisted as a predictor of in-hospital mortality (OR = 3.789; P = .006). BMI was not a predictor of in-hospital mortality for either sex.
The researchers noted that patients who were at risk for malnutrition accounted for only 6.56% of the cohort, whereas medical records lacked information on previous treatment of patients.
“Nutrition treatment education and implementation should be an integral part of the therapeutic process,” the researchers wrote. “Monitoring the nutritional status of patients during hospitalization, extensive malnutrition prevention activities and the selection of appropriate interventions for malnourished patients should be part of the therapeutic process. Starting nutritional treatment in malnourished patients as soon as possible can affect prognosis [and] show prognostic and economic significance.”
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