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Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Nutritional status during hospitalization is associated with the long-term prognosis of patients with heart failure
Takuma Takada1, Kentaro Jujo1, Keiko Inagaki2
1Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054, Japan.
Insights
Changes in nutritional status, measured by the CONtrolling NUTritional status (CONUT) score, during hospitalization impact heart failure (HF) patient outcomes. Improving nutritional status may reduce cardiovascular events and HF readmissions post-discharge.
Area of Science:
- Cardiology
- Nutritional Science
- Clinical Medicine
Background:
- The CONtrolling NUTritional status (CONUT) score assesses nutritional status in heart failure (HF) patients.
- High admission CONUT scores correlate with increased cardiovascular (CV) event risk in HF patients.
- The effect of CONUT score changes during hospitalization on long-term HF prognosis remains unclear.
Purpose of the Study:
- To investigate the impact of CONUT score changes during hospitalization on clinical outcomes of HF patients after discharge.
- To analyze the association between nutritional status fluctuations and post-discharge CV events and HF readmissions.
Main Methods:
- Observational study of 1705 hospitalized HF patients discharged alive.
- Patients categorized by admission and discharge CONUT scores: persistently high, high-to-normal, normal-to-high, persistently normal.
- Primary endpoint: composite of CV death and HF readmission; median follow-up 525 days.
Main Results:
- The composite endpoint occurred in 38% of patients.
- Persistently high CONUT scores were associated with the highest composite endpoint rate (P < 0.001).
- Improving CONUT scores from high to normal at discharge significantly reduced the hazard ratio for composite outcomes (HR: 0.69; 95% CI: 0.49-0.98) compared to persistently high scores.
Conclusions:
- Nutritional status changes during HF hospitalization are linked to post-discharge CV events.
- Interventions to improve nutritional status in HF patients may enhance clinical outcomes.
- Monitoring and managing CONUT score dynamics during hospitalization is crucial for HF patient prognosis.
Aims:
The CONtrolling NUTritional status (CONUT) score represents the nutritional status of patients with heart failure (HF). Although high CONUT scores on admission are associated with increased risks of cardiovascular (CV) events in patients with HF, the impact of CONUT changes during hospitalization on their long-term prognosis is unclear. This study aimed to investigate the impact of CONUT score changes on the clinical outcomes of patients with HF after discharge.
Methods And Results:
This observational study included 1705 patients hospitalized with HF who were discharged alive. The patients were categorized depending on their CONUT scores at admission and discharge into persistently high, high at admission and normal at discharge, normal at admission and high at discharge, and persistently normal CONUT groups. The primary endpoint was a composite of CV death and readmission for HF after discharge. The primary endpoint occurred in 652 patients (38%) during the median 525 day follow-up period. Patients with persistently high CONUT scores had the highest composite endpoint rate (log-rank trend test: P < 0.001). After adjusting for covariates, the hazard ratio for the composite outcome was significantly lower for the patients with high CONUT scores at admission and normal CONUT scores at discharge than that for those with persistently high CONUT scores (hazard ratio: 0.69; 95% confidence interval: 0.49-0.98).
Conclusions:
Nutritional status changes in patients with HF that occurred during hospitalization were associated with CV events after discharge. Improving the nutritional status of patients may improve their clinical outcomes.
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