Shoroq Saber Mohamed
Ministry of Health, Egypt
Abstract Title: Early Individualized Nutritional Support Improves Survival in Hospitalized Egyptian Patients with Chronic Heart Failure: A Multicenter Randomized Study
Biography:
I am a 30 year physical therapy specialist with a strong academic interest in Nutrition and obesity management. I have a clinical diploma in that field and aspiring to be a presenter abroad
Research Interests:
Background: Malnutrition is a major yet under recognized determinant of poor outcomes among patients hospitalized with chronic heart failure (CHF), particularly in low-resource healthcare systems. Regional evidence evaluating the impact of early nutritional intervention remains limited. Objectives: To investigate the effect of protocol-guided individualized nutritional support on short- and mid-term mortality and cardiovascular outcomes in hospitalized Egyptian patients with CHF at nutritional risk. Methods: This multicenter, open-label randomized controlled trial enrolled 768 adult patients admitted with CHF across four tertiary Egyptian hospitals. All patients had Nutritional Risk Screening 2002 (NRS-2002) scores ≥3. Participants were randomized to receive individualized nutritional support targeting caloric, protein, and micronutrient requirements (intervention group, n=384) or standard hospital diet (control group, n=384). The primary endpoint was 30-day all-cause mortality. Secondary endpoints included 180-day mortality, major adverse cardiovascular events (MACE), re-hospitalization, and functional recovery. Cox proportional hazard models were used for adjusted analyses. Results: Increasing nutritional risk was independently associated with higher 180-day mortality (adjusted hazard ratio [HR] per 1-point increase in NRS-2002: 1.52; 95% CI: 1.28–1.81; p<0.001). At 30 days, mortality was significantly lower in the intervention group compared with controls (6.8% vs. 13.1%; adjusted HR: 0.47; 95% CI: 0.31–0.72; p<0.001). Survival benefit persisted at 180 days (13.9% vs. 22.4%; adjusted HR: 0.56; 95% CI: 0.42–0.75; p<0.001). Patients with severe malnutrition (NRS-2002 ≥5) demonstrated the greatest risk reduction. Additionally, individualized nutritional support significantly reduced 30-day MACE (16.2% vs. 25.7%; adjusted HR: 0.61; 95% CI: 0.46–0.80; p=0.001) and HF-related rehospitalization. Conclusions: Early individualized nutritional support significantly improves survival and cardiovascular outcomes among hospitalized Egyptian patients with CHF at nutritional risk. Routine nutritional screening and targeted nutritional therapy should be integrated into standard heart failure inpatient care pathways.
