AUTHOR=Chen Zhezhe , Jiang Hangpan , He Wujian , Li Duanbin , Lin Maoning , Wang Min , Shang Min , Zhang Wenbin 

TITLE=The Association of Nutritional Risk Screening 2002 With 1-Year Re-hospitalization and the Length of Initial Hospital Stay in Patients With Heart Failure

JOURNAL=Frontiers in Nutrition

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.849034

DOI=10.3389/fnut.2022.849034

ISSN=2296-861X

ABSTRACT=<sec><title>Backgrounds and Aims</title><p>Nutritional Risk Screening 2002 (NRS-2002) has been widely recommended for identifying the nutritional risk. However, the association between NRS-2002 and the prognosis of heart failure has not been fully addressed. This study aimed to explore the association of NRS-2002 with 1-year re-hospitalization and the length of initial hospital stay in heart failure patients.</p></sec><sec><title>Methods</title><p>This retrospective study included 2,830 heart failure patients. The primary endpoint was 1-year re-hospitalization for heart failure. The secondary endpoint was the length of initial hospital stay. The Log-binomial regression analysis was performed to determine the association between NRS-2002 and re-hospitalization. The Cox regression model was fitted to estimate hazard of discharge. The cumulative incidence curves of discharge were plotted using Kaplan–Meier method and log-rank test was performed. Exploratory analysis was also conducted according to the classification of heart failure and the level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) fold-elevation.</p></sec><sec><title>Results</title><p>Among 2,830 heart failure patients, the mean age was 64.3 years and 66.4% were male. A total of 122 (4.3%) patients were considered at high nutritional risk. Log-binomial regression analysis demonstrated that higher NRS-2002 score was an independent risk factor of re-hospitalization ([1 vs. 0]: relative risks [<italic>RR</italic>] = 1.383, 95% <italic>CI</italic> = 1.152 to 1.660; [2 vs. 0]: <italic>RR</italic> = 1.425, 95% <italic>CI</italic> = 1.108 to 1.832; [3–7 vs. 0]: <italic>RR</italic> = 1.770, 95% <italic>CI</italic> = 1.310 to 2.393). Kaplan–Meier curve showed that the cumulative incidence of discharge was lower in high nutritional risk group (Log rank <italic>p</italic> &lt; 0.001). Cox regression analysis also found that higher NRS-2002 score (2 or ≥3) was strongly associated with longer length of initial hospital stay ([2 vs. 0]: Hazard ratios [<italic>HR</italic>] = 0.854, 95% <italic>CI</italic> = 0.748 to 0.976; [3–7 vs. 0]: <italic>HR</italic> = 0.609, 95% <italic>CI</italic> = 0.503 to 0.737). Exploratory analysis showed that such association still remained irrespective of NT-proBNP fold-elevation, but only existed in patients with heart failure with preserved ejection fraction (HFpEF).</p></sec><sec><title>Conclusion</title><p>In patients with heart failure, high NRS-2002 score was strongly and independently associated with the incidence of 1-year re-hospitalization and the length of initial hospital stay.</p></sec>