Effect of nutritional status on adverse clinical events in elderly patients with nonvalvular atrial fibrillation: A retrospective cohort study

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Annals of Noninvasive Electrocardiology Pub Date : 2024-06-26 DOI:10.1111/anec.13130

Kan Zhang MM, Ying Sun MD, Jiancao Ding MM, Qing Ma MD, Dai Zhang MM, Wei Huang MM, Yunli Xing MD

{"title":"Effect of nutritional status on adverse clinical events in elderly patients with nonvalvular atrial fibrillation: A retrospective cohort study","authors":"Kan Zhang MM, Ying Sun MD, Jiancao Ding MM, Qing Ma MD, Dai Zhang MM, Wei Huang MM, Yunli Xing MD","doi":"10.1111/anec.13130","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>To explore the influence of nutritional status on adverse clinical events in elderly patients with nonvalvular atrial fibrillation.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This retrospective observational cohort study included 196 patients, 75–102-years-old, with nonvalvular atrial fibrillation, hospitalized in our hospital. The nutritional status was assessed using Mini-Nutritional Assessment—Short Form (MNA-SF). Patients with MNA-SF scores of 0–11 and 12–14 were included in the malnutrition and nonmalnutrition groups, respectively.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The average age of the malnutrition group was higher than that of the nonmalnutrition group, and the levels of body mass index (BMI), hemoglobin (HGB), and albumin (ALB) were significantly lower than those of the nonmalnutrition group, with statistical significance (<i>p</i> < .05). The incidence of all-cause death in the malnutrition group was higher than that in the nonmalnutrition group (<i>p</i> = .007). Kaplan–Meier curve indicated that malnutrition patients have a higher risk of all-cause death (log-rank test, <i>p</i> = .001) and major bleeding events (<i>p</i> = .017). Multivariate Cox proportional hazard regression analysis corrected for confounders showed that malnutrition was an independent risk factor of all-cause death (HR = 1.780, 95%CI:1.039–3.050, <i>p</i> = .036). The malnutrition group had a significantly high incidence of major bleeding than the nonmalnutrition group (<i>p</i> = .026), and there was no significant difference in the proportion of anticoagulation therapy (<i>p</i> = .082) and the incidence of ischemic stroke/systemic embolism (<i>p</i> = .310) between the two groups.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Malnutrition is an independent risk factor of all-cause death in elderly patients with atrial fibrillation. The incidence of major bleeding in malnourished elderly patients with atrial fibrillation is high, and the benefit of anticoagulation therapy is not obvious.</p>\n </section>\n </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"29 4","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11208721/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Noninvasive Electrocardiology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/anec.13130","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

To explore the influence of nutritional status on adverse clinical events in elderly patients with nonvalvular atrial fibrillation.

Methods

This retrospective observational cohort study included 196 patients, 75–102-years-old, with nonvalvular atrial fibrillation, hospitalized in our hospital. The nutritional status was assessed using Mini-Nutritional Assessment—Short Form (MNA-SF). Patients with MNA-SF scores of 0–11 and 12–14 were included in the malnutrition and nonmalnutrition groups, respectively.

Results

The average age of the malnutrition group was higher than that of the nonmalnutrition group, and the levels of body mass index (BMI), hemoglobin (HGB), and albumin (ALB) were significantly lower than those of the nonmalnutrition group, with statistical significance (p < .05). The incidence of all-cause death in the malnutrition group was higher than that in the nonmalnutrition group (p = .007). Kaplan–Meier curve indicated that malnutrition patients have a higher risk of all-cause death (log-rank test, p = .001) and major bleeding events (p = .017). Multivariate Cox proportional hazard regression analysis corrected for confounders showed that malnutrition was an independent risk factor of all-cause death (HR = 1.780, 95%CI:1.039–3.050, p = .036). The malnutrition group had a significantly high incidence of major bleeding than the nonmalnutrition group (p = .026), and there was no significant difference in the proportion of anticoagulation therapy (p = .082) and the incidence of ischemic stroke/systemic embolism (p = .310) between the two groups.

Conclusions

Malnutrition is an independent risk factor of all-cause death in elderly patients with atrial fibrillation. The incidence of major bleeding in malnourished elderly patients with atrial fibrillation is high, and the benefit of anticoagulation therapy is not obvious.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

营养状况对老年非瓣膜性心房颤动患者不良临床事件的影响：一项回顾性队列研究。

目的：探讨营养状况对非瓣膜性心房颤动老年患者不良临床事件的影响：探讨营养状况对老年非瓣膜性心房颤动患者不良临床事件的影响：这项回顾性观察队列研究纳入了在我院住院的 196 名 75-102 岁非瓣膜性心房颤动患者。研究人员使用迷你营养评估简表（MNA-SF）对患者的营养状况进行了评估。MNA-SF评分为0-11分和12-14分的患者分别被纳入营养不良组和非营养不良组：结果：营养不良组的平均年龄高于非营养不良组，体重指数（BMI）、血红蛋白（HGB）和白蛋白（ALB）的水平显著低于非营养不良组，差异有统计学意义（P 结论：营养不良是一种独立的风险因素：营养不良是老年心房颤动患者全因死亡的独立风险因素。营养不良的老年心房颤动患者大出血的发生率很高，抗凝治疗的益处并不明显。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Annals of Noninvasive Electrocardiology 医学-心血管系统

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation. ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.