Screening of nutritional risk, sarcopenia and frailty in older inpatients with coronary heart disease

doi:10.3877/cma.j.issn.2095-8757.2024.02.002

Abstract

Abstract:

Objective

To screen and analyze the prevalence of nutritional risk, sarcopenia and frailty in hospitalized elderly patients with coronary heart disease.

Methods

Patients aged 60 and over who were hospitalized in the Cardiology Department of the Second Hospital of Tianjin Medical University from May to August 2023 and were definitely diagnosed with coronary heart disease were collected, and the patients were randomly selected according to the hospitalization number for sampling investigation. Nutritional Risk Screening Scale (NRS2002), SARC-CalF Scale and FRAIL Scale were used to screen nutritional risk, sarcopenia and frailty respectively, and malnutrition and chronic heart failure were diagnosed according to the GLIM criteria for the diagnosis of malnutrition and the criteria in National Heart Failure Guide 2023. T test, rank sum test and chi-square test were used to compare the differences of nutritional risk, sarcopenia and frailty among patients with or without heart failure, and analyze the correlation between nutritional indicators and heart failure indicators by multiple linear regression analysis.

Results

A total of 378 elderly inpatients with coronary heart disease were collected, including 111 cases with heart failure. Among 378 patients, the incidence rates of nutritional risk, malnutrition, sarcopenia and frailty were 16.93%, 5.55%, 6.35% and 21.95% respectively, and the incidence rates of nutritional risk, sarcopenia and frailty in heart failure group were higher than those in non-heart failure group (χ²=32.330, 4.519, 42.024; P < 0.05 or P < 0.01). N-terminal pro-brain natriuretic peptide (NT-proBNP) level was negatively correlated with hemoglobin level (B=-58.410, P < 0.05), but positively correlated with FRAIL scale score (B=2 128.215, P < 0.05). The area under the curve of NT-proBNP was 0.88 (0.67, 1.00), and when NT-proBNP≥3 181.85 ng/L, its sensitivity and specificity for diagnosing frailty were 0.80 and 0.94.

Conclusion

The incidence of malnutrition, frailty and sarcopenia is high in elderly patients with coronary heart disease, especially in elderly patients with heart failure. For patients with NT-proBNP≥3181.85 ng/L, it is suggested to conduct a comprehensive screening and evaluation of frailty.

Key words: Coronary heart disease, Heart failure, Nutritional risk, Malnutrition, Sarcopenia, Frailty, N-terminal B-type brain natriuretic peptide precursor, Screen

Jingran Cao, Fuqiang Dong, Lijian Zhang, Changle Liu, Yukun Zhang, Kangyin Chen. Screening of nutritional risk, sarcopenia and frailty in older inpatients with coronary heart disease[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2024, 11(02): 5-9.

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References 33

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组别	例数	年龄（岁）	血红蛋白（g/L）	白蛋白（g/L）	营养风险	营养不良	肌少症	衰弱
心力衰竭患者	111	72±2	107±5	34.9±0.9	51（45.9）	12（10.8）	15（13.5）	66（59.5）
非心力衰竭患者	267	66±1	128±3	40.1±0.5	12（4.5）	9（3.4）	9（3.4）	18（6.7）
检验值		t=-2.468	t=4.213	t=5.752	χ²=32.330	χ²=2.751	χ²=4.519	χ²=42.024
P值		<0.05	<0.01	<0.01	<0.01	>0.05	<0.05	<0.01

组别	例数	年龄（岁）	血红蛋白（g/L）	白蛋白（g/L）	营养风险	营养不良	肌少症	衰弱
心力衰竭患者	111	72±2	107±5	34.9±0.9	51（45.9）	12（10.8）	15（13.5）	66（59.5）
非心力衰竭患者	267	66±1	128±3	40.1±0.5	12（4.5）	9（3.4）	9（3.4）	18（6.7）
检验值		t=-2.468	t=4.213	t=5.752	χ²=32.330	χ²=2.751	χ²=4.519	χ²=42.024
P值		<0.05	<0.01	<0.01	<0.01	>0.05	<0.05	<0.01

自变量	B值	t值	P值
血红蛋白	-58.410	-2.044	<0.05
白蛋白	-90.458	-0.697	>0.05
NRS2002	-887.315	-1.483	>0.05
SARC-CalF	-8.765	-0.286	>0.05
FRAIL	2128.215	2.682	<0.05

自变量	B值	t值	P值
血红蛋白	-58.410	-2.044	<0.05
白蛋白	-90.458	-0.697	>0.05
NRS2002	-887.315	-1.483	>0.05
SARC-CalF	-8.765	-0.286	>0.05
FRAIL	2128.215	2.682	<0.05

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