Assessment of Malnutrition in Heart Failure and Its Relationship with Clinical Problems in Brazilian Health Services
Abstract
:1. Introduction
2. Methodology
2.1. Study Design
2.2. Study Sample Selection
2.3. Socioeconomic, Clinical and Lifestyle Data
2.4. Nutritional Assessment
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | All | Private | Public | p 1 |
---|---|---|---|---|
n (%) | n (%) | n (%) | ||
Sex | 247 | 68 | 179 | 0.371 |
Male | 124 (50.2) | 32 (47.1) | 92 (51.4) | |
Female | 123 (49.8) | 36 (52.9) | 87 (48.6) | |
Age | 247 (100) | 68 (100) | 179 (100) | <0.001 |
<60 years old | 113 (45.7) | 6 (8.8) | 107 (59.8) | |
≥60 years old | 134 (54.3) | 62 (91.2) | 72 (40.2) | |
Schooling (years)(a) | 237 | 60 | 177 | <0.001 |
0 | 52 (21.9) | 5 (8.3) | 47 (26.6) | |
1 to 9 | 139 (58.6) | 25 (41.7) | 114 (64.4) | |
≥10 | 46 (19.4) | 30 (50) | 16 (9.0) | |
Per capita income2 | 213 | 43 | 170 | <0.001 |
≤BRL 1212.00/month | 178 (83.6) | 16 (37.2) | 162 (95.3) | |
>BRL 1212.00/month | 35 (16.4) | 27 (62.8) | 8 (4.7) | |
Etiology | 247 | 68 | 179 | 0.028 |
Not Specified | 22 (8.9) | 12 (17.6) | 10 (5.6) | |
Hypertensive | 69 (27.9) | 20 (29.4) | 49 (27.4) | |
Valvulopathy | 61 (24.7) | 10 (14.7) | 51 (28.5) | |
Cardiomyopathy | 45 (18.2) | 13 (19.1) | 32 (17.9) | |
Ischemic | 43 (17.4) | 12 (17.6) | 31 (17.3) | |
Other 3 | 7 (2.8) | 1 (1.5) | 6 (3.4) | |
NYHA4 (b) | 246 | 68 | 178 | 0.074 |
I and II | 23 (9.3) | 10 (14.7) | 13 (7.3) | |
III and IV | 223 (90.7) | 58 (85.3) | 165 (92.7) | |
Type of heart failure (LVEF) 5 | 213 | 43 | 170 | 0.592 |
Reduced | 82 (38.9) | 22 (34.9) | 60 (40.5) | |
Intermediary | 42 (19.9) | 15 (23.8) | 27 (18.2) | |
Preserved | 87 (41.2) | 26 (41.3) | 61 (41.2) | |
Comorbidities | ||||
Arrhythmia | 112 (46.1) | 37 (55.2) | 75 (42.6) | 0.078 |
Depression | 34 (13.8) | 13 (19.1) | 21 (11.7) | 0.132 |
Diabetes | 92 (37.2) | 29 (42.6) | 63 (35.2) | 0.279 |
Dyslipidemia | 108 (43.9) | 39 (57.4) | 69 (38.8) | 0.009 |
Peripheral arterial disease | 29 (11.7) | 8 (11.8) | 21 (11.7) | 0.994 |
Chronic obstructive pulmonary disease (COPD) | 29 (11.7) | 14 (20.6) | 15 (8.4) | 0.008 |
Arterial hypertension | 170 (68.8) | 49 (72.1) | 121 (67.6) | 0.499 |
Renal insufficiency | 39 (15.9) | 12 (17.6) | 27 (15.2) | 0.634 |
Health history (prior to hospitalization) | ||||
Stroke/transient ischemic attack | 37 (15.0) | 10 (14.7) | 27 (15.1) | 0.941 |
Cancer | 17 (6.9) | 12 (17.6) | 5 (2.8) | <0.001 |
Acute myocardial infarction | 57 (23.1) | 19 (27.9) | 38 (21.2) | 0.263 |
Coronary artery disease (family history) | 70 (28.5) | 26 (38.2) | 44 (24.7) | 0.036 |
Lifestyle (prior to hospitalization) | ||||
Alcoholic beverage (consumption) (c) | 31 (12.6) | 8 (11.9) | 23 (12.8) | 0.848 |
smoking | 7 (2.8) | 0 (0) | 7 (3.9) | 0.195 |
Physical activity level (d) | 224 | 61 | 163 | 0.013 |
Short | 188 (83.9) | 44 (72.1) | 144 (88.3) | |
Intermediary | 26 (11.6) | 12 (19.7) | 14 (8.6) | |
High | 10 (4.5) | 5 (8.2) | 5 (3.1) |
Variables | Total | Private | Public | p 3 |
---|---|---|---|---|
n (%) | n (%) | n (%) | ||
BMI1 | 215 | 67 | 148 | 0.119 |
Nourished | 180 (83.7) | 60 (89.6) | 120 (81.1) | |
Malnutrition | 35 (16.3) | 7 (10.4) | 28 (18.9) | |
SGA/MNA2 | 247 | 68 | 179 | 0.793 |
Nourished | 61 (24.7) | 16 (23.5) | 45 (25.1) | |
Risk/Malnutrition | 186 (75.3) | 52 (76.5) | 134 (74.9) |
Outcomes | Total | Private | Public | p 2 |
---|---|---|---|---|
n (%) | n (%) | n (%) | ||
Hospitalization period (days) | 247 | 68 | 179 | 0.609 |
≤7 | 59 (23.9) | 19 (27.9) | 40 (22.3) | |
7 to 14 | 80 (32.4) | 22 (32.4) | 58 (32.4) | |
>14 | 108 (43.7) | 27 (39.7) | 81 (45.3) | |
Of treatment1 | 246 | 68 | 178 | <0.001 |
Hospital discharge | 191 (77.6) | 65 (95.6) | 126 (70.8) | |
Transfer | 39 (15.9) | 0 (0) | 39 (21.9) | |
Death | 16 (6.5) | 3 (4.4) | 13 (7.3) | |
After discharge (<30 days) | 158 | 47 | 111 | 0.039 |
None | 109 (69.0) | 37 (78.7) | 72 (64.9) | |
Readmission/Emergency | 36 (22.8) | 10 (21.3) | 26 (23.4) | |
Death | 13 (8.2) | 0 (0) | 13 (11.7) |
Outcomes | Total | Malnutrition 1 | Nourished | p 3 |
---|---|---|---|---|
n (%) | n (%) | n (%) | ||
Hospitalization period (days) | 247 | 186 | 61 | 0.020 |
≤7 | 59 (23.9) | 38 (20.4) | 21 (34.4) | |
7 to14 | 80 (32.4) | 58 (31.2) | 22 (36.1) | |
>14 | 108 (43.7) | 90 (48.4) | 18 (29.5) | |
Of treatment2 | 246 | 185 | 61 | 0.756 |
Hospital discharge | 191 (77.6) | 144 (77.8) | 47 (77.0) | |
Transfer | 39 (15.9) | 28 (15.1) | 11 (18.0) | |
Death | 16 (6.5) | 13 (7.0) | 3 (4.9) | |
After discharge (<30 days) | 158 | 116 | 42 | 0.634 |
None | 109 (69.0) | 79 (68.1) | 30 (71.4) | |
Readmission/Emergency | 36 (22.8) | 26 (22.4) | 10 (23.8) | |
Death | 13 (8.2) | 11 (9.5) | 2 (4.8) |
Outcomes | Malnutrition 1 | p 3 | |
---|---|---|---|
Private | Public | ||
n (%) | n (%) | ||
Hospitalization period (days) | 52 | 134 | 0.820 |
≤7 | 10 (19.2) | 28 (20.9) | |
7 to 14 | 18 (34.6) | 40 (29.9) | |
>14 | 24 (46.2) | 66 (49.3) | |
Of treatment2 | 52 | 133 | |
Hospital discharge | 49 (94.2) | 95 (71.4) | 0.001 |
Transfer | 0 (0) | 28 (21.1) | |
Death | 3 (5.8) | 10 (7.5) | |
After discharge (<30 days) | 35 | 81 | 0.071 |
None | 26 (74.3) | 53 (65.4) | |
Readmission/Emergency | 9 (25.7) | 17 (21.0) | |
Death | 0 (0) | 11 (13.6) |
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Barbosa, J.S.; Souza, M.F.C.d.; Costa, J.O.; Alves, L.V.S.; Oliveira, L.M.S.M.d.; Almeida, R.R.d.; Oliveira, V.B.; Pereira, L.M.C.; Rocha, R.M.S.; Costa, I.M.N.B.d.C.; et al. Assessment of Malnutrition in Heart Failure and Its Relationship with Clinical Problems in Brazilian Health Services. Int. J. Environ. Res. Public Health 2022, 19, 10090. https://doi.org/10.3390/ijerph191610090
Barbosa JS, Souza MFCd, Costa JO, Alves LVS, Oliveira LMSMd, Almeida RRd, Oliveira VB, Pereira LMC, Rocha RMS, Costa IMNBdC, et al. Assessment of Malnutrition in Heart Failure and Its Relationship with Clinical Problems in Brazilian Health Services. International Journal of Environmental Research and Public Health. 2022; 19(16):10090. https://doi.org/10.3390/ijerph191610090
Chicago/Turabian StyleBarbosa, Juliana Santos, Márcia Ferreira Cândido de Souza, Jamille Oliveira Costa, Luciana Vieira Sousa Alves, Larissa Marina Santana Mendonça de Oliveira, Rebeca Rocha de Almeida, Victor Batista Oliveira, Larissa Monteiro Costa Pereira, Raysa Manuelle Santos Rocha, Ingrid Maria Novais Barros de Carvalho Costa, and et al. 2022. "Assessment of Malnutrition in Heart Failure and Its Relationship with Clinical Problems in Brazilian Health Services" International Journal of Environmental Research and Public Health 19, no. 16: 10090. https://doi.org/10.3390/ijerph191610090