Prognostic Significance of Malnutrition and Physical Function in Patients With Heart Failure

Malnutrition and impaired physical function are common comorbidities of heart failure (HF). We investigated the relationship between malnutrition and physical function, factors associated with these values, and their prognostic impact on clinical outcomes.

We retrospectively analyzed 151 patients with HF to determine the correlation between the nutritional index, assessed using the controlling nutritional status (CONUT) score, and physical function, assessed using the short physical performance battery (SPPB). We analyzed the prognostic role of nutrition and physical function for the composite endpoints of death or HF hospitalization. The median CONUT and SPPB scores were 3 (1, 4) and 11 (8, 12), respectively. These scores showed a significant but weak correlation (r=-0.214; P=0.008). While the CONUT and SPPB scores were a significant predictor of the composite endpoint in univariable Cox analysis, only the CONUT score remained significant after adjustment for confounders. Factors associated with the CONUT score were hemoglobin and B-type natriuretic peptide levels, and those associated with the SPPB score were age, sex, and CONUT score. Using established cutoffs (i.e., CONUT ≥5, SPPB ≤9), malnutrition remained independently associated with the composite endpoint (adjusted hazard ratio 2.56; 95% confidence interval 1.46-4.48; P<0.001).

Malnutrition and poor physical function had a weak correlation and factors associated while these values were different. Both predicted a poor prognosis and need to be assessed in patients with HF.