Date of Award

Spring 5-7-2016

Document Type

Thesis

Degree Name

Master of Science (MS)

Programs

Medical Sciences Interdepartmental Area

First Advisor

Dr. Corrine Hanson

Second Advisor

Dr. Ann Anderson Berry

Third Advisor

Raquel Thomas

Abstract

Background: Current research estimates that approximately 50 percent of heart failure patients are categorized as malnourished. Heart failure patients are at increased risk of malnourishment due to increased catabolic processes that increase resting energy expenditure, decrease appetite, impair nutrient absorption, and lead to unintentional weight loss. The goal of standardized diagnostic criteria is to identify malnutrition early for more effective treatment. Current studies suggest the association of early diagnosis and nutrition intervention with increased positive patient outcomes and improved quality of life for heart failure (HF) patients. However, the proportion of patients with HF who meet criteria for malnutrition at Nebraska Medicine is unknown.

Purpose: The purpose of this study was to determine the proportion of patients with a diagnosis of HF who met criteria for malnutrition upon admission at Nebraska Medicine based on the American Society for Parenteral and Enteral Nutrition (ASPEN) guidelines. The secondary aim was to identify if patient characteristics are associated with a diagnosis of malnutrition based on ASPEN guidelines.

Methods: A retrospective chart review was conducted of 100 patients flagged with the core measure of heart failure upon admission. The patients were divided into two groups based on ASPEN guidelines for malnutrition; malnourished (meeting > 2 criteria) and non-malnourished (meetingcriteria). Clinical patient characteristics were collected to determine if significant differences between the groups exist.

Results: Out of 100 study participants, 39 percent of participants were categorized as malnourished by ASPEN criteria. When assessing the criteria for malnutrition, the largest percentage of patients met diagnosis due to decreased functional status and fluid accumulation with 85 percent and 69 percent respectively. There were a larger percentage of females in the malnourished group as compared to the non-malnourished group (46% vs 26% respectively, p=0.04). Nutrition status was significantly different between the groups with COPD; with 18 percent in the malnourished group, and 43 percent in the non-malnourished group (p=0.01).

Conclusion: Our study reports, 39 percent of heart failure patients are found to be malnourished upon admission at Nebraska Medicine. Based on our results females are more likely malnourished than males and those diagnosed with COPD were less likely to be malnourished.

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