Ann Geriatr Med Res.
2024 Jun;28(2):171-177. 10.4235/agmr.23.0213.
Predicting Mortality Risks Using Body Mass Index and Weight Loss at Admission in Patients with Heart Failure
- Affiliations
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- 1Department of Nutrition, Aichi Medical University Hospital, Nagakute, Aichi, Japan
- 2Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan
- 3Nutritional Therapy Support Center, Aichi Medical University, Nagakute, Aichi, Japan
- 4Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu Aichi, Japan
- 5School of Medical Technology, Kurume University, Fukuoka, Japan
- 6Biostatistics Center, Kurume University, Kurume, Fukuoka, Japan
- 7Department of Food and Health Science, Faculty of Health and Human Development, The University of Nagano, Nagano, Japan
- 8Department of Nutritional Service, NTT Medical Center Tokyo, Tokyo, Japan
- 9Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan
- 10Department of Physical Therapy, Niigata University of Health and Welfare, Shimamicho, Niigata, Japan
- KMID: 2556718
- DOI: http://doi.org/10.4235/agmr.23.0213
Abstract
- Background
The association of the combination of body mass index (BMI) and weight change at admission with prognoses in patients with heart failure (HF) is unclear. Therefore, we investigated whether BMI and weight changes at admission affect mortality in patients with HF.
Methods
This retrospective cohort study lasted 99 months, starting in April 2014, and included 4,862 patients with HF from a Japanese real-world database. Cubic and thin-plate smoothing spline analyses were performed to investigate the association of BMI and weight changes with mortality. The percentage weight change was calculated every 6 months. The study outcome was the presence or absence of death.
Results
The patients’ mean age was 81.5±9.6 years, and 1,239 (25.5%) patients died. Cubic spline analysis revealed a negative correlation of BMI with mortality hazard ratio (HR) (BMI of 18.5 kg/m2 and 25 kg/m2; HR=1.3 [1.2–1.4] and 0.8 [0.7–0.9], respectively). Cubic spline analysis of weight change showed that weight loss tended to increase the mortality HR (each 6% decrease in weight change rate was associated with a 1.1 times higher mortality risk (95% CI [1.0–1.2]) Thin-plate smoothing spline analysis showed that the odds ratio (OR) negatively correlated with BMI (1-year mortality: BMI of 18.5 kg/m2, 22 kg/m2, and 25 kg/m2; OR at 0% weight change=1.5, 1.0, and 0.7, respectively; 2-year mortality: BMI=18.5 kg/m2, 22 kg/m2, and 25 kg/m2; OR at 0% weight change=1.4, 0.9, and 0.7, respectively).
Conclusion
A low BMI in patients with HF was associated with a higher risk of mortality. Weight loss in patients, regardless of BMI, was associated with a higher OR for mortality.
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