Sex differences in the association between nutritional status and in‐hospital mortality in HFpEF patients
Abstract Aims The study aimed to assess whether the effect of nutritional risk score (NRS‐2002) on the odds of in‐hospital mortality would be modulated by sex and body mass index (BMI) in patients with heart failure with preserved ejection fraction (HFpEF). Methods and results A retrospective analys...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-08-01
|
| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.15332 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849708705945223168 |
|---|---|
| author | Michał Czapla Adrian Kwaśny Izabella Uchmanowicz Łukasz Pietrzykowski Christopher S. Lee Wojciech Kosowski Stanisław Surma Halina Grajeta Łukasz Lewandowski |
| author_facet | Michał Czapla Adrian Kwaśny Izabella Uchmanowicz Łukasz Pietrzykowski Christopher S. Lee Wojciech Kosowski Stanisław Surma Halina Grajeta Łukasz Lewandowski |
| author_sort | Michał Czapla |
| collection | DOAJ |
| description | Abstract Aims The study aimed to assess whether the effect of nutritional risk score (NRS‐2002) on the odds of in‐hospital mortality would be modulated by sex and body mass index (BMI) in patients with heart failure with preserved ejection fraction (HFpEF). Methods and results A retrospective analysis was conducted on 234 patients admitted with acute heart failure, in whom HFpEF was identified as the underlying diagnosis, during the period 08.2018–08.2020. Nutritional status was assessed using BMI and NRS2002. NRS‐2002 is a validated screening tool recommended by ESPEN that evaluates nutritional risk based on recent weight loss, reduced dietary intake, severity of illness and age. Logistic regression models were used to evaluate the associations between these nutritional indices and in‐hospital mortality. The models were adjusted for sex, age and comorbidities. Interactions between NRS2002, BMI and sex were also explored to assess whether the effect of nutritional status on mortality was modulated by these factors. The analysis revealed that male patients with elevated NRS2002 scores had significantly higher odds of in‐hospital mortality (odds = 47.512 at NRS2002 = 4 compared to odds = 0.031 at NRS2002 = 1; BMI = 28 in both cases). BMI negatively modulated the odds of death (OR = 0.843, P = 0.012) in the population sample. This effect was consistent across the sample regardless of NRS2002 score, as NRS2002 did not significantly influence the BMI–mortality relationship (P = 0.289). Importantly, this relationship was observed only in male patients, as no such association between NRS2002 and mortality was found in women. Conclusions In male patients with HFpEF, elevated NRS2002 scores showed significantly higher odds of in‐hospital mortality. Higher BMI was generally associated with lower odds of mortality, with this protective effect remaining consistent in the population sample, regardless of the NRS2002 score. |
| format | Article |
| id | doaj-art-8167699779644255b1b73d42657e31f8 |
| institution | DOAJ |
| issn | 2055-5822 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-8167699779644255b1b73d42657e31f82025-08-20T03:15:34ZengWileyESC Heart Failure2055-58222025-08-011242499250610.1002/ehf2.15332Sex differences in the association between nutritional status and in‐hospital mortality in HFpEF patientsMichał Czapla0Adrian Kwaśny1Izabella Uchmanowicz2Łukasz Pietrzykowski3Christopher S. Lee4Wojciech Kosowski5Stanisław Surma6Halina Grajeta7Łukasz Lewandowski8Division of Scientific Research and Innovation in Emergency Medical Service, Department of Emergency Medical Service Faculty of Nursing and Midwifery, Wroclaw Medical University Wroclaw PolandInstitute of Dietetics Academy of Business and Health Science Łódź PolandDepartment of Nursing, Faculty of Nursing and Midwifery Wroclaw Medical University Wroclaw PolandDepartment of Cardiac Rehabilitation and Health Promotion Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz Bydgoszcz PolandBoston College William F. Connell School of Nursing Chestnut Hill Massachusetts USAInstitute of Heart Diseases Wroclaw Medical University Wroclaw PolandDepartment of Internal Medicine and Clinical Pharmacology Medical University of Silesia Katowice PolandDepartment of Dietetics and Bromatology Wroclaw Medical University Wroclaw PolandDepartment of Medical Biochemistry Wroclaw Medical University Wroclaw PolandAbstract Aims The study aimed to assess whether the effect of nutritional risk score (NRS‐2002) on the odds of in‐hospital mortality would be modulated by sex and body mass index (BMI) in patients with heart failure with preserved ejection fraction (HFpEF). Methods and results A retrospective analysis was conducted on 234 patients admitted with acute heart failure, in whom HFpEF was identified as the underlying diagnosis, during the period 08.2018–08.2020. Nutritional status was assessed using BMI and NRS2002. NRS‐2002 is a validated screening tool recommended by ESPEN that evaluates nutritional risk based on recent weight loss, reduced dietary intake, severity of illness and age. Logistic regression models were used to evaluate the associations between these nutritional indices and in‐hospital mortality. The models were adjusted for sex, age and comorbidities. Interactions between NRS2002, BMI and sex were also explored to assess whether the effect of nutritional status on mortality was modulated by these factors. The analysis revealed that male patients with elevated NRS2002 scores had significantly higher odds of in‐hospital mortality (odds = 47.512 at NRS2002 = 4 compared to odds = 0.031 at NRS2002 = 1; BMI = 28 in both cases). BMI negatively modulated the odds of death (OR = 0.843, P = 0.012) in the population sample. This effect was consistent across the sample regardless of NRS2002 score, as NRS2002 did not significantly influence the BMI–mortality relationship (P = 0.289). Importantly, this relationship was observed only in male patients, as no such association between NRS2002 and mortality was found in women. Conclusions In male patients with HFpEF, elevated NRS2002 scores showed significantly higher odds of in‐hospital mortality. Higher BMI was generally associated with lower odds of mortality, with this protective effect remaining consistent in the population sample, regardless of the NRS2002 score.https://doi.org/10.1002/ehf2.15332BMIHeart failureHFpEFNRS2002Nutritional statusObesity |
| spellingShingle | Michał Czapla Adrian Kwaśny Izabella Uchmanowicz Łukasz Pietrzykowski Christopher S. Lee Wojciech Kosowski Stanisław Surma Halina Grajeta Łukasz Lewandowski Sex differences in the association between nutritional status and in‐hospital mortality in HFpEF patients ESC Heart Failure BMI Heart failure HFpEF NRS2002 Nutritional status Obesity |
| title | Sex differences in the association between nutritional status and in‐hospital mortality in HFpEF patients |
| title_full | Sex differences in the association between nutritional status and in‐hospital mortality in HFpEF patients |
| title_fullStr | Sex differences in the association between nutritional status and in‐hospital mortality in HFpEF patients |
| title_full_unstemmed | Sex differences in the association between nutritional status and in‐hospital mortality in HFpEF patients |
| title_short | Sex differences in the association between nutritional status and in‐hospital mortality in HFpEF patients |
| title_sort | sex differences in the association between nutritional status and in hospital mortality in hfpef patients |
| topic | BMI Heart failure HFpEF NRS2002 Nutritional status Obesity |
| url | https://doi.org/10.1002/ehf2.15332 |
| work_keys_str_mv | AT michałczapla sexdifferencesintheassociationbetweennutritionalstatusandinhospitalmortalityinhfpefpatients AT adriankwasny sexdifferencesintheassociationbetweennutritionalstatusandinhospitalmortalityinhfpefpatients AT izabellauchmanowicz sexdifferencesintheassociationbetweennutritionalstatusandinhospitalmortalityinhfpefpatients AT łukaszpietrzykowski sexdifferencesintheassociationbetweennutritionalstatusandinhospitalmortalityinhfpefpatients AT christopherslee sexdifferencesintheassociationbetweennutritionalstatusandinhospitalmortalityinhfpefpatients AT wojciechkosowski sexdifferencesintheassociationbetweennutritionalstatusandinhospitalmortalityinhfpefpatients AT stanisławsurma sexdifferencesintheassociationbetweennutritionalstatusandinhospitalmortalityinhfpefpatients AT halinagrajeta sexdifferencesintheassociationbetweennutritionalstatusandinhospitalmortalityinhfpefpatients AT łukaszlewandowski sexdifferencesintheassociationbetweennutritionalstatusandinhospitalmortalityinhfpefpatients |