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Nutritional screening based on the controlling nutritional status (CONUT) score at the time of admission is useful for long-term prognostic prediction in patients with heart failure requiring hospitalization

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Abstract

The objective of the study was to clarify whether controlling nutritional status (CONUT) is useful for predicting the long-term prognosis of patients hospitalized with heart failure (HF). A total of 482 (57.5%) HF patients from the Ibaraki Cardiovascular Assessment Study-HF (N = 838) were enrolled (298 men, 71.7 ± 13.6 years). At admission, blood samples were collected and nutritional status assessed using CONUT. CONUT scores were defined as follows: 0–1, normal; 2–4, light; 5–8, moderate; and 9–12, severe undernutrition. Accordingly, 352 (73%) patients had light-to-severe nutritional disturbances. In the follow-up period [median 541.5 (range 354–786) days], 109 deaths were observed. A Kaplan–Meier analysis revealed that all-cause deaths occurred more frequently in HF patients with nutritional disturbances [n = 93 (26.4%)] than in those with normal nutrition [n = 16 (12.3%); log-rank p < 0.001]. The Cox proportional hazard analyses revealed that a per point increase in the CONUT score was associated with an increased risk of all-cause death (hazard ratio 1.142; 95% confidence interval, 1.044–1.249) after controlling simultaneously for age, sex, previous history of HF hospitalization, log brain natriuretic peptide, and use of therapeutic agents at admission (tolvaptan and aldosterone antagonists). This study suggests that nutritional screening using CONUT scores is helpful in predicting the long-term prognosis of patients hospitalized with HF in a multicenter registry setting.

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Acknowledgements

We thank Koichi Hashimoto and the staff at the Tsukuba Clinical Research and Development Organization (T-CReDO) for supporting data management. List of participating hospitals and investigators: Akihiro Suzuki, Haruhiko Higuchi (Hitachi General Hospital), Takayoshi Yamanouchi, Ryo Kawamura (Hitachinaka General Hospital), Rihito Yamada (Mito Medical Center), Noriyuki Takeyasu, Daisuke Abe (Ibaraki Prefectural Central Hospital), Yuichi Noguchi, Hidetaka Nishina (Tsukuba Medical Center Hospital), Tsuyoshi Enomoto, Masayuki Igawa (Tsukuba Memorial Hospital), Kimito Ishikawa (Ryugasaki Saiseikai General Hospital), Hiroshi Maeda (Ibaraki Seinan Medical Center Hospital), Masae Endo, Ikuo Yoshida (Moriya Daiichi General Hospital).

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Authors and Affiliations

  1. Department of Cardiology, Tsuchiura Clinical Education and Training Center, University of Tsukuba Hospital, Tsuchiura, Japan

    Isao Nishi

  2. Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan

    Yoshihiro Seo, Yoshie Hamada-Harimura, Kimi Sato, Masayoshi Yamamoto & Kazutaka Aonuma

  3. Department of Cardiology, Hitachi, Ltd., Hitachinaka General Hospital, Hitachinaka, Japan

    Seika Sai

  4. Department of Clinical Laboratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan

    Tomoko Ishizu

  5. Division of Cardiology, Ryugasaki Saiseikai General Hospital, Ryugasaki, Japan

    Akinori Sugano & Kenichi Obara

  6. Department of Cardiology, National Hospital Organization Kasumigaura Medical Center, 2-7-14 Shimotakatsu, Tsuchiura, Ibaraki, 300-8585, Japan

    Isao Nishi, Longmei Wu & Shoji Suzuki

  7. Medical Science, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan

    Akira Koike

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  1. Isao Nishi
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Consortia

Ibaraki Cardiovascular Assessment Study-Heart Failure Investigators

  • Akihiro Suzuki
  • , Haruhiko Higuchi
  • , Takayoshi Yamanouchi
  • , Ryo Kawamura
  • , Rihito Yamada
  • , Noriyuki Takeyasu
  • , Daisuke Abe
  • , Yuichi Noguchi
  • , Hidetaka Nishina
  • , Tsuyoshi Enomoto
  • , Masayuki Igawa
  • , Kimito Ishikawa
  • , Hiroshi Maeda
  • , Masae Endo
  •  & Ikuo Yoshida

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Correspondence to Isao Nishi.

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The authors declare that they have no conflicts of interest or financial relationships relevant to this study.

Additional information

Investigators in the Ibaraki Cardiovascular Assessment Study-Heart Failure registry are listed in Acknowledgements.

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Nishi, I., Seo, Y., Hamada-Harimura, Y. et al. Nutritional screening based on the controlling nutritional status (CONUT) score at the time of admission is useful for long-term prognostic prediction in patients with heart failure requiring hospitalization. Heart Vessels 32, 1337–1349 (2017). https://doi.org/10.1007/s00380-017-1001-8

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