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Influence of nutritional status on early outcomes of elderly patients admitted with acute myocardial infarction
Author(s) -
Hirakawa Yoshihisa,
Masuda Yuichiro,
Kuzuya Masafumi,
Iguchi Akihisa,
Kimata Takaya,
Uemura Kazumasa
Publication year - 2006
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/j.1447-0594.2006.00353.x
Subject(s) - medicine , malnutrition , myocardial infarction , body mass index , heart failure , percutaneous coronary intervention , blood pressure , mortality rate , serum albumin , prospective cohort study , cardiology
Background: The impact of malnutrition on early outcomes has not been studied widely in acute myocardial infarction (AMI). This study aimed at determining the effect of malnutrition on in‐hospital mortality or duration of hospital stay in the elderly AMI patient. Method: Data from the Tokai Acute Myocardial Infarction Study II were used. This was a prospective study of all patients admitted to 15 hospitals with AMI. We abstracted the baseline and procedural characteristics, serum albumin level, and in‐hospital mortality from detailed chart reviews. Patients aged 65 and over were stratified into two groups according to serum albumin concentration. Results: The present analysis included a subsample of 629 patients with serum albumin concentration <35 g/L (undernutrition group) and 962 patients with serum albumin concentration ≥35 g/L (normal nutrition group). Patients in the undernutition group were older, more likely to be dependent in activities of daily living, and have a lower systolic blood pressure or a lower body mass index score, a history of renal failure, and signs of heart failure on presentation. Also, patients in this group frequently had a reduced left ventricular function and multivessel coronary disease. They were more likely to receive vasopressors, intra‐aortic balloon pump, or mechanical ventilation, and were less likely to receive percutaneous coronary intervention. Although undernutrition group patients had a significantly higher mortality rate or a longer duration of stay than normal nutrition group patients, the differences disappeared after multivariable adjustment. Conclusions: Malnutrition of elderly AMI patients was not associated with poor early outcomes.