Heart and Vessels

, Volume 32, Issue 11, pp 1337–1349 | Cite as

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

  • Isao Nishi
  • Yoshihiro Seo
  • Yoshie Hamada-Harimura
  • Kimi Sato
  • Seika Sai
  • Masayoshi Yamamoto
  • Tomoko Ishizu
  • Akinori Sugano
  • Kenichi Obara
  • Longmei Wu
  • Shoji Suzuki
  • Akira Koike
  • Kazutaka Aonuma
  • Ibaraki Cardiovascular Assessment Study-Heart Failure Investigators
Original Article

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.

Keywords

CONUT score Heart failure Nutritional screening Prognosis 

Notes

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).

Compliance with ethical standards

Conflict of interest

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

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Copyright information

© Springer Japan 2017

Authors and Affiliations

  • Isao Nishi
    • 1
    • 6
  • Yoshihiro Seo
    • 2
  • Yoshie Hamada-Harimura
    • 2
  • Kimi Sato
    • 2
  • Seika Sai
    • 3
  • Masayoshi Yamamoto
    • 2
  • Tomoko Ishizu
    • 4
  • Akinori Sugano
    • 5
  • Kenichi Obara
    • 5
  • Longmei Wu
    • 6
  • Shoji Suzuki
    • 6
  • Akira Koike
    • 7
  • Kazutaka Aonuma
    • 2
  • Ibaraki Cardiovascular Assessment Study-Heart Failure Investigators
  1. 1.Department of Cardiology, Tsuchiura Clinical Education and Training CenterUniversity of Tsukuba HospitalTsuchiuraJapan
  2. 2.Cardiovascular Division, Faculty of MedicineUniversity of TsukubaTsukubaJapan
  3. 3.Department of CardiologyHitachi, Ltd., Hitachinaka General HospitalHitachinakaJapan
  4. 4.Department of Clinical Laboratory Medicine, Faculty of MedicineUniversity of TsukubaTsukubaJapan
  5. 5.Division of CardiologyRyugasaki Saiseikai General HospitalRyugasakiJapan
  6. 6.Department of CardiologyNational Hospital Organization Kasumigaura Medical CenterTsuchiuraJapan
  7. 7.Medical Science, Faculty of MedicineUniversity of TsukubaTsukubaJapan

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