Abstract：
Nutritional risk screening is fundamental to prevent undesirable outcomes in heart failure (HF). Current reviews of nutritional screening tools encompass both hospitalized and outpatient settings, which may not be suitable because of different clinical manifestations. We hypothesize that multidimensional tools would better identify prognosis of decompensated patients because the tools assess more than isolated aspects. This systematic review aims to explore the association of multidimensional nutritional risk screening tools and prognosis in patients hospitalized with decompensated HF. Five databases were searched for studies that assessed nutritional risk through multidimensional screening tools and its association with prognosis in adults hospitalized with decompensated HF. The 95% confidence interval and relative risk were computed using a random-effects model. Inverse variance method was used. Thirty-eight studies were included. Most studies demonstrated higher nutritional risk was significantly associated with worse prognosis. Quantitative analysis identified higher nutritional risk by using the Mini Nutritional Assessment Short Form (MNA-SF), Controlling Nutritional Status, Geriatric Nutritional Risk Index, and Prognostic Nutritional Index to be associated with all-cause mortality. The MNA-SF demonstrated greater magnitude of association with all-cause mortality in older subjects (relative risk, 4.85; 95% confidence interval, 2.0-11.75). Higher nutritional risk was associated with poor prognosis and higher mortality in patients hospitalized with decompensated HF, especially when screened by MNA-SF. Tools were not directly compared. That might reinforce the importance of evaluating multiple aspects when screening hospitalized HF patients once symptoms associated with decompensation frequently mask the underlying nutritional status and risk. PROSPERO registration number (CRD42021256271).
摘要：
营养风险筛查是预防心力衰竭（HF）不良后果的基础。当前对营养筛查工具的审查包括住院和门诊设置，这可能是不合适的，因为不同的临床表现。我们假设多维工具可以更好地识别失代偿患者的预后，因为该工具评估的不仅仅是孤立的方面。本系统评价旨在探讨多维度营养风险筛查工具与失代偿性HF住院患者预后的关系。在五个数据库中搜索了通过多维筛查工具评估营养风险的研究及其与失代偿性HF住院成人预后的关系。使用随机效应模型计算95%置信区间和相对风险。采用逆方差法。包括38项研究。大多数研究表明，较高的营养风险与较差的预后显着相关。定量分析通过使用迷你营养评估简表(MNA-SF)确定了更高的营养风险，控制营养状况，老年营养风险指数，和预后营养指数与全因死亡率相关。在老年受试者中，MNA-SF与全因死亡率的相关性更大(相对风险，4.85；95%置信区间，2.0-11.75)。在失代偿性HF住院患者中，较高的营养风险与不良预后和较高的死亡率相关。尤其是在MNA-SF筛查时。工具没有直接比较。一旦与失代偿相关的症状经常掩盖潜在的营养状况和风险，这可能会加强在筛查住院HF患者时评估多个方面的重要性。PROSPERO注册号(CRD42021256271)。
