Nutritional Risk and Mortality at One Year for Elderly Patients Hospitalized with Nonvalvular Atrial Fibrillation. Nonavasc Registry.

Objectives: To determine whether nutritional risk is associated with the mortality of elderly patients hospitalized with nonvalvular atrial fibrillation (NVAF).
Design: Prospective, multicenter cohort study.
Setting: Internal medicine departments in Spain.
Participants: Inpatients >75 years with NVAF.
Measurements: We measured the thrombotic and hemorrhagic risk at admission using the CHA2DS2-VASc and HAS-BLED scales, respectively, and the nutritional risk with the controlling nutritional status (CONUT) index. We established 4 degrees of nutritional risk: null (CONUT score 0-1 point), low (2-4 points), moderate (5-8 points) and high (9-12 points). We also conducted a 1-year follow-up.
Results: We included 449 patients, with a mean age of 85.2(5.2) years. The nutritional risk was null for 70(15.6%) patients, low for 206 45.9%), moderate for 152(33.8%) and high for 21(4.7%). At the end of one year, 177(39.4%) patients had died. The score on the CONUT index was higher for the deceased patients (4.6 vs. 3.6, p<0.001). The CONUT score (HR, 1.076; 95%CI 1.009-1.148; p=0.025), the Charlson index (HR, 1.080; 95%CI 1.017-1.148; p=0.013) and the presence of pressure ulcers (HR, 1.700; 95%CI 1.028-2.810; p=0.039) were independently associated with increased mortality at one year of follow-up. The prescription of oral anticoagulants at discharge was associated with lower mortality (HR, 0.440; 95%CI 0.304-0.638; p<0.001).
Conclusions: More than a third of elderly patients hospitalized with NVAF have a moderate to high nutritional risk. These patients have greater mortality at the end of one year.
Competing Interests: The authors declare that they have no conflict of interest. Aranzazu Arenas Miquélez has no conflict of interest. María Ángeles Calleja Requena has no conflict of interest. Alejandra Gullón has no conflict of interest. Antonio Pose Reino has no conflict of interest. Françesc Formiga has no conflict of interest. Miguel Camafort has no conflict of interest. José María Cepeda Rodrigo has no conflict of interest. José María Mostaza has no conflict of interest. Carmen Suárez Fernández has no conflict of interest. Jesús Díez-Manglano has no conflict of interest.