P605Lower body mass index in patients with acute heart failure is independently associated with higher mortality and hospitalization by dehydration in community-based registry; KICKOFF Registry

Abstract

Background: Body mass index (BMI) is associated with mortality, but in the patients with heart failure (HF) the association with BMI and mortality and other outcomes have not been well documented in the Asian Pacific region, Japan. Purpose: The purpose of this study is to identify the association of low BMI and outcome of mortality, hospitalization of HF and hospitalization by dehydration, in patients with acute heart failure (AHF). Methods: The KICKOFF Registry is a prospective multicenter cohort study of HF patients. We have enrolled 746 patients with AHF at 13 hospitals in Kitakawachi which is located at the eastern end of the city of Osaka, Japan, from April 2015 to January 2017. The patients were categorized to three groups: BMI <18kg/m2 (low BMI; n=110), 18 kg/m2≤ BMI <25kg/m2 (normal BMI; n=489) or BMI ≤25 kg/m2 (high BMI; n=147). We compared the clinical characteristics and outcomes between the low BMI and the other groups. Result: The patients with low BMI were older, female more, and longer mean length of hospitalization than the other groups (low BMI vs. normal BMI vs. high BMI: 83.4±9.5 vs. 77.2±10.9 vs. 72.2±13.0 years of age; p<0.01, 63.6% vs. 47.2% vs. 41.5%; p<0.01, 83.4±9.5 vs. 77.2±10.9 vs. 72.2±13.0 days; p<0.01, respectively). They had more valvular disease and dementia than the other groups. They had less hypertension, diabetes mellitus, dyslipidemia or chronic obstructive pulmonary disease. In Kaplan-Meier analyses, there was no significant difference with hospitalization of HF. However, the mortality and the hospitalization by dehydration were higher in low BMI than the other groups during six-month follow-up (p<0.01). After the adjustment by gender, age, and the other comorbidities in multiple logistic regression models, low BMI was independently associated with the mortality (hazard ratio, 1.31; 95% confidence interval, 1.2- 4.3; p=0.01), and the hospitalization by dehydration (hazard ratio, 2.99; 95% confidence interval, 1.82-9.55; p<0.01). Conclusion: The HF patients with low BMI is independently associated with higher mortality and hospitalization by dehydration. Therefore, we should care and consider more about the treatment of low BMI. (Figure Presented).