In hospitalized patients with acute HF and moderate to severe malnutrition, improvement in CONUT score during hospitalization was associated with lower post-discharge mortality and rehospitalization.
Key Findings
Results
All-cause mortality was significantly lower in patients whose nutritional status improved during hospitalization compared to those whose did not improve.
All-cause mortality was 11.90% in the improvement (IMP) group vs. 30.12% in the non-improvement (Non-IMP) group.
Log-rank P < 0.0001 for the difference in all-cause mortality between groups.
Median follow-up was 712 days (IQR, 392–768 days).
812 patients with moderate or severe malnutrition (CONUT score ≥5) at admission were analyzed, stratified into IMP (n = 168) and Non-IMP (n = 644) groups.
Results
The composite endpoint of all-cause mortality and HF rehospitalization was significantly lower in the nutritional improvement group.
Composite endpoint occurred in 29.76% of the IMP group vs. 47.98% of the Non-IMP group.
Log-rank P < 0.0001 for the composite endpoint difference between groups.
The composite endpoint included all-cause mortality and HF rehospitalization.
Results
After propensity score matching, the IMP group still had consistently lower all-cause mortality and composite endpoints.
Log-rank P = 0.0002 for all-cause mortality after propensity score matching.
Log-rank P = 0.041 for the composite endpoint after propensity score matching.
Propensity score matching was used to control for confounding between the IMP and Non-IMP groups.
Results
CONUT score improvement during hospitalization was independently associated with lower all-cause mortality in a multivariable analysis using overlap weighting.
HR for CONUT improvement and all-cause mortality was 0.357 (95% CI, 0.205–0.624; P = 0.0003).
Analysis used a multivariable Cox proportional hazards model with overlap weighting.
This represents approximately a 64% reduction in risk of all-cause mortality associated with nutritional status improvement.
Background
Malnutrition is common in heart failure patients and longitudinal changes in nutritional status of HF patients are poorly investigated.
The study analyzed data on 4,016 patients from a nationwide acute HF registry in Japan (UMIN ID: UMIN000036592).
Of 4,016 total patients, 812 (approximately 20%) had moderate or severe malnutrition at admission defined by CONUT score ≥5.
The Controlling Nutritional Status (CONUT) score was used as the nutritional assessment tool.
The study identified malnutrition as associated with poor outcomes in HF based on prior literature.
Okabe T, Kida K, Enzan N, Ikeda M, Okumura T, Kitai T, et al.. (2026). Prognostic Value of In-Hospital Nutritional Status Improvement in Heart Failure: Insights From JROADHF-NEXT Registry.. Global heart. https://doi.org/10.5334/gh.1534