Association of weight change and in‐hospital mortality in patients with repeated hospitalization for heart failure
Abstract Background Although weight loss in heart failure (HF) is a detrimental condition known as cachexia, weight gain caused by fluid retention should also be considered harmful. However, studies with sufficient number of patients examining the impact of weight change and its interval on in‐hospi...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-02-01
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| Series: | Journal of Cachexia, Sarcopenia and Muscle |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jcsm.13170 |
| _version_ | 1797805582340587520 |
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| author | Masaaki Konishi Hidehiro Kaneko Hidetaka Itoh Satoshi Matsuoka Akira Okada Kentaro Kamiya Tadafumi Sugimoto Katsuhito Fujiu Nobuaki Michihata Taisuke Jo Norifumi Takeda Hiroyuki Morita Kouichi Tamura Hideo Yasunaga Issei Komuro |
| author_facet | Masaaki Konishi Hidehiro Kaneko Hidetaka Itoh Satoshi Matsuoka Akira Okada Kentaro Kamiya Tadafumi Sugimoto Katsuhito Fujiu Nobuaki Michihata Taisuke Jo Norifumi Takeda Hiroyuki Morita Kouichi Tamura Hideo Yasunaga Issei Komuro |
| author_sort | Masaaki Konishi |
| collection | DOAJ |
| description | Abstract Background Although weight loss in heart failure (HF) is a detrimental condition known as cachexia, weight gain caused by fluid retention should also be considered harmful. However, studies with sufficient number of patients examining the impact of weight change and its interval on in‐hospital mortality in HF have not been conducted thus far. We sought to elucidate the association of weight change with in‐hospital mortality in patients with HF. Methods This retrospective observational study used data from the Diagnosis Procedure Combination database, a nationwide inpatient health claims database in Japan. In total, 48 234 patients repeatedly hospitalized for HF (median 82 [74–87] years; 46.4% men) between 2010 and 2018 were included. Weight change was derived from body weight at the first and second admissions. Results The median weight change and interval between two hospitalizations were −3.1 [−8.3 to −1.8] % and 172 [67–420] days, with 66.9% of overall cohort experiencing any weight loss. As a result of multivariable‐adjusted logistic regression analysis, weight loss <−5.0% and weight gain >+5.0% were associated with increased in‐hospital mortality (adjusted odds ratio [OR] [95% confidence interval]: 1.46 [1.31–1.62], P < 0.001 and 1.23 [1.08–1.40], P = 0.002, respectively) whereas mild weight loss and gain of 2.0–5.0% were not (OR [95% confidence interval]: 0.96 [0.84–1.10], P = 0.57 and 1.07 [0.92–1.25], P = 0.37, respectively), in comparison with patients with a stable weight (fluctuating no more than −2.0% to +2.0%) used as a reference. Restrictive cubic spline models adjusted for multiple background factors illustrated that higher mortality in patients with weight loss was observed across all subgroups of the baseline body mass index (<18.5, 18.5–24.9 and ≥25.0 kg/m2). In patients with short (<90 days) and middle (<180 days) intervals between the two hospitalizations, both weight loss and weight gain were associated with high mortality, whereas the association between weight gain and high mortality was attenuated in those with longer intervals. Conclusions Both weight loss and weight gain in patients with repeated hospitalization for HF were associated with high in‐hospital mortality, especially weight loss and short/middle‐term weight gain. Such patients should be treated with caution in a setting of repeated hospitalization for HF. |
| first_indexed | 2024-03-13T05:54:13Z |
| format | Article |
| id | doaj.art-c6ca7400ac764c379ae8cec248704330 |
| institution | Directory Open Access Journal |
| issn | 2190-5991 2190-6009 |
| language | English |
| last_indexed | 2024-03-13T05:54:13Z |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Cachexia, Sarcopenia and Muscle |
| spelling | doaj.art-c6ca7400ac764c379ae8cec2487043302023-06-13T07:50:50ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092023-02-0114164265210.1002/jcsm.13170Association of weight change and in‐hospital mortality in patients with repeated hospitalization for heart failureMasaaki Konishi0Hidehiro Kaneko1Hidetaka Itoh2Satoshi Matsuoka3Akira Okada4Kentaro Kamiya5Tadafumi Sugimoto6Katsuhito Fujiu7Nobuaki Michihata8Taisuke Jo9Norifumi Takeda10Hiroyuki Morita11Kouichi Tamura12Hideo Yasunaga13Issei Komuro14Department of Medical Science and Cardiorenal Medicine Yokohama City University Graduate School of Medicine Yokohama JapanDepartment of Cardiovascular Medicine and Department of Advanced Cardiology The University of Tokyo Tokyo JapanDepartment of Cardiovascular Medicine The University of Tokyo Tokyo JapanDepartment of Cardiovascular Medicine New Tokyo Hospital Matsudo JapanDepartment of Prevention of Diabetes and Lifestyle‐Related Diseases, Graduate School of Medicine The University of Tokyo Tokyo JapanDepartment of Rehabilitation, School of Allied Health Sciences Kitasato University Sagamihara JapanDepartment of Cardiology and Nephrology Mie University Graduate School of Medicine Tsu JapanDepartment of Cardiovascular Medicine and Department of Advanced Cardiology The University of Tokyo Tokyo JapanDepartment of Health Services Research The University of Tokyo Tokyo JapanDepartment of Health Services Research The University of Tokyo Tokyo JapanDepartment of Cardiovascular Medicine The University of Tokyo Tokyo JapanDepartment of Cardiovascular Medicine The University of Tokyo Tokyo JapanDepartment of Medical Science and Cardiorenal Medicine Yokohama City University Graduate School of Medicine Yokohama JapanDepartment of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo Tokyo JapanDepartment of Cardiovascular Medicine The University of Tokyo Tokyo JapanAbstract Background Although weight loss in heart failure (HF) is a detrimental condition known as cachexia, weight gain caused by fluid retention should also be considered harmful. However, studies with sufficient number of patients examining the impact of weight change and its interval on in‐hospital mortality in HF have not been conducted thus far. We sought to elucidate the association of weight change with in‐hospital mortality in patients with HF. Methods This retrospective observational study used data from the Diagnosis Procedure Combination database, a nationwide inpatient health claims database in Japan. In total, 48 234 patients repeatedly hospitalized for HF (median 82 [74–87] years; 46.4% men) between 2010 and 2018 were included. Weight change was derived from body weight at the first and second admissions. Results The median weight change and interval between two hospitalizations were −3.1 [−8.3 to −1.8] % and 172 [67–420] days, with 66.9% of overall cohort experiencing any weight loss. As a result of multivariable‐adjusted logistic regression analysis, weight loss <−5.0% and weight gain >+5.0% were associated with increased in‐hospital mortality (adjusted odds ratio [OR] [95% confidence interval]: 1.46 [1.31–1.62], P < 0.001 and 1.23 [1.08–1.40], P = 0.002, respectively) whereas mild weight loss and gain of 2.0–5.0% were not (OR [95% confidence interval]: 0.96 [0.84–1.10], P = 0.57 and 1.07 [0.92–1.25], P = 0.37, respectively), in comparison with patients with a stable weight (fluctuating no more than −2.0% to +2.0%) used as a reference. Restrictive cubic spline models adjusted for multiple background factors illustrated that higher mortality in patients with weight loss was observed across all subgroups of the baseline body mass index (<18.5, 18.5–24.9 and ≥25.0 kg/m2). In patients with short (<90 days) and middle (<180 days) intervals between the two hospitalizations, both weight loss and weight gain were associated with high mortality, whereas the association between weight gain and high mortality was attenuated in those with longer intervals. Conclusions Both weight loss and weight gain in patients with repeated hospitalization for HF were associated with high in‐hospital mortality, especially weight loss and short/middle‐term weight gain. Such patients should be treated with caution in a setting of repeated hospitalization for HF.https://doi.org/10.1002/jcsm.13170body weightheart failuremortality |
| spellingShingle | Masaaki Konishi Hidehiro Kaneko Hidetaka Itoh Satoshi Matsuoka Akira Okada Kentaro Kamiya Tadafumi Sugimoto Katsuhito Fujiu Nobuaki Michihata Taisuke Jo Norifumi Takeda Hiroyuki Morita Kouichi Tamura Hideo Yasunaga Issei Komuro Association of weight change and in‐hospital mortality in patients with repeated hospitalization for heart failure Journal of Cachexia, Sarcopenia and Muscle body weight heart failure mortality |
| title | Association of weight change and in‐hospital mortality in patients with repeated hospitalization for heart failure |
| title_full | Association of weight change and in‐hospital mortality in patients with repeated hospitalization for heart failure |
| title_fullStr | Association of weight change and in‐hospital mortality in patients with repeated hospitalization for heart failure |
| title_full_unstemmed | Association of weight change and in‐hospital mortality in patients with repeated hospitalization for heart failure |
| title_short | Association of weight change and in‐hospital mortality in patients with repeated hospitalization for heart failure |
| title_sort | association of weight change and in hospital mortality in patients with repeated hospitalization for heart failure |
| topic | body weight heart failure mortality |
| url | https://doi.org/10.1002/jcsm.13170 |
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