Risk factors associated with malnutrition in elderly patients with chronic heart failure

This retrospective observational study aimed to identify clinical determinants of malnutrition in elderly patients with chronic heart failure. Elderly patients (≥65 years) with established chronic heart failure managed at a single tertiary hospital between January 2022 and December 2024 were included. Malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition criteria, using a 2-step approach combining risk screening and phenotypic and etiologic assessment. Demographic, anthropometric, comorbidity, laboratory, and heart failure-related data were extracted from electronic medical records. Univariate and multivariate logistic regression analyses were performed to explore factors associated with malnutrition, and model performance was evaluated using receiver operating characteristic analysis. Among 203 patients, 36 (17.7%) were classified as malnourished. Compared with non-malnourished patients, those with malnutrition were older and had a lower body mass index, lower serum albumin and prealbumin, higher C-reactive protein and neutrophil-to-lymphocyte ratio, poorer renal function, higher N-terminal pro-B-type natriuretic peptide levels, and a higher prevalence of New York Heart Association class III/IV and chronic obstructive pulmonary disease. In multivariate analysis, older age, lower body mass index, higher New York Heart Association class, elevated C-reactive protein, presence of chronic obstructive pulmonary disease, reduced estimated glomerular filtration rate, and higher N-terminal pro-B-type natriuretic peptide remained independently associated with malnutrition. The final model showed good discriminatory performance, with an area under the curve of 0.902, supporting its potential utility for nutritional risk stratification in this population.