Agreement and classification performance of malnutrition tools in patients with chronic heart failure

Sze, Shirley and Pellicori, Pierpaolo and Zhang, Jufen and Weston, Joan and Clark, Andrew L. (2020) Agreement and classification performance of malnutrition tools in patients with chronic heart failure. Current Developments in Nutrition, 4 (6). nzaa071. ISSN 2475-2991

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Official URL: https://doi.org/10.1093/cdn/nzaa071

Abstract

Background: Malnutrition is common in chronic heart failure (CHF) patients and is associated with adverse outcome, but few data exist. Objectives: To report the prevalence of malnutrition and classification performance of 6 malnutrition tools in CHF patients. Methods: Controlling nutritional status index (CONUT); geriatric nutritional risk index (GNRI); prognostic nutritional index (PNI); malnutrition universal screening tool (MUST); mini nutritional assessment-short form (MNA-SF); and subjective global assessment (SGA) were used to evaluate malnutrition. Since there is no “gold-standard” for malnutrition evaluation, for each of the malnutrition tools, we used the results of the other 5 tools to produce a standard combined index. Subjects were ‘malnourished’ if so identified by ≥3/5 tools. Results: We studied 467 consecutive ambulatory CHF patients (67% male, median age 76 (IQR: 69–82) years, median NTproBNP 1156 (IQR: 469–2463) ng/L). The prevalence of any degree and at least moderate malnutrition ranged between 6–60% and 3–9% respectively, with CONUT classifying the highest proportion of subjects as malnourished. Malnourished patients tended to be older, have worse symptoms, higher NT-proBNP and more co-morbidities. CONUT had the highest sensitivity (80%), MNA-SF and SGA had the highest specificity (99%) and MNA-SF had the lowest misclassification rate (2%) in identifying at least moderate malnutrition as defined by the combined index. Conclusion: Malnutrition is common in CHF patients. The prevalence of malnutrition varies depending on the tool used. Amongst the 6 malnutrition tool studied, MNA-SF has the best classification performance in identifying significant malnutrition as defined by the combined index.

Item Type: Journal Article
Keywords: heart failure, malnutrition, screening, assessment
Faculty: Faculty of Health, Education, Medicine & Social Care
Depositing User: Ian Walker
Date Deposited: 01 Apr 2020 21:55
Last Modified: 09 Sep 2021 18:53
URI: https://arro.anglia.ac.uk/id/eprint/705378

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