Biomaterial Database

Home-Delivered Meals Postdischarge From Heart Failure Hospitalization. 2018

Scott L Hummel, and Wahida Karmally, and Brenda W Gillespie, and Stephen Helmke, and Sergio Teruya, and Joanna Wells, and Erika Trumble, and Omar Jimenez, and Cara Marolt, and Jeffrey D Wessler, and Maria L Cornellier, and Mathew S Maurer

University of Michigan Frankel Cardiovascular Center, Ann Arbor (S.L.H., B.W.G., J.W., C.M., M.C.).

Background In patients with heart failure (HF), malnutrition and dietary sodium excess are common and may worsen outcomes. No prior studies have provided low-sodium, nutritionally complete meals following HF hospitalization. Methods and Results The GOURMET-HF study (Geriatric Out-of-Hospital Randomized Meal Trial in Heart Failure) randomized patients discharged from HF hospitalization to 4 weeks of home-delivered sodium-restricted Dietary Approaches to Stop Hypertension meals (DASH/SRD; 1500 mg sodium/d) versus usual care. The primary outcome was the between-group change in the Kansas City Cardiomyopathy Questionnaire summary score from discharge to 4 weeks postdischarge. Additional outcomes included changes in the Kansas City Cardiomyopathy Questionnaire clinical summary score and cardiac biomarkers. All patients were followed 12 weeks for death/all-cause readmission and potential diet-related adverse events (symptomatic hypotension, hyperkalemia, acute kidney injury). Sixty-six patients were randomized 1:1 at discharge to DASH/SRD versus usual care (age, 71±8 years; 30% female; ejection fraction, 39±18%). The Kansas City Cardiomyopathy Questionnaire summary score increased similarly between groups (DASH/SRD 46±23-59±20 versus usual care 43±19-53±24; P=0.38), but the Kansas City Cardiomyopathy Questionnaire clinical summary score increase tended to be greater in DASH/SRD participants (47±22-65±19 versus 45±20-55±26; P=0.053). Potentially diet-related adverse events were uncommon; 30-day HF readmissions (11% versus 27%; P=0.06) and days rehospitalized within that timeframe (17 versus 55; P=0.055) trended lower in DASH/SRD participants. Conclusions Home-delivered DASH/SRD after HF hospitalization appeared safe in selected patients and had directionally favorable effects on HF clinical status and 30-day readmissions. Larger studies are warranted to clarify the effects of postdischarge nutritional support in patients with HF. Clinical Trial Registration URL: https://www.clinicaltrials.gov . Unique identifier: NCT02148679.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008824	Michigan	State bounded on the north by the Great Lakes, on the east by Canada, on the south by Wisconsin, Indiana, and Ohio, and on the west by Lake Michigan and Wisconsin.
D009519	New York City	City located at the mouth of the Hudson River, in New York State.
D009752	Nutritional Status	State of the body in relation to the consumption and utilization of nutrients.	Nutrition Status,Status, Nutrition,Status, Nutritional
D009753	Nutritive Value	An indication of the contribution of a food to the nutrient content of the diet. This value depends on the quantity of a food which is digested and absorbed and the amounts of the essential nutrients (protein, fat, carbohydrate, minerals, vitamins) which it contains. This value can be affected by soil and growing conditions, handling and storage, and processing.	Biological Availability, Nutritional,Nutritional Availability,Availability, Biological Nutritional,Availability, Nutritional Biologic,Biologic Availability, Nutritional,Biologic Nutritional Availability,Nutrition Value,Nutritional Availability, Biologic,Nutritional Availability, Biological,Nutritional Biological Availability,Nutritional Food Quality,Nutritional Quality,Nutritional Value,Nutritive Quality,Availability, Biologic Nutritional,Availability, Nutritional,Availability, Nutritional Biological,Biological Nutritional Availability,Food Quality, Nutritional,Nutrition Values,Nutritional Biologic Availability,Nutritional Values,Nutritive Values,Quality, Nutritional,Quality, Nutritional Food,Quality, Nutritive,Value, Nutrition,Value, Nutritional,Value, Nutritive,Values, Nutrition,Values, Nutritional,Values, Nutritive
D010351	Patient Discharge	The administrative process of discharging the patient, alive or dead, from hospitals or other health facilities.	Discharge Planning,Discharge Plannings,Discharge, Patient,Discharges, Patient,Patient Discharges,Planning, Discharge,Plannings, Discharge
D010359	Patient Readmission	Subsequent admissions of a patient to a hospital or other health care institution for treatment.	Hospital Readmission,Rehospitalization,Unplanned Hospital Readmissions,Unplanned Readmission,30 Day Readmission,Hospital Readmissions,Readmission, Hospital,Readmissions, Hospital,Thirty Day Readmission,30 Day Readmissions,Hospital Readmission, Unplanned,Hospital Readmissions, Unplanned,Readmission, Patient,Readmission, Thirty Day,Readmission, Unplanned,Rehospitalizations,Thirty Day Readmissions,Unplanned Hospital Readmission,Unplanned Readmissions
D011788	Quality of Life	A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease.	HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D011795	Surveys and Questionnaires	Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions.	Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D004039	Diet, Sodium-Restricted	A diet which contains very little sodium chloride. It is prescribed by some for hypertension and for edematous states. (Dorland, 27th ed)	Diet, Low-Salt,Diet, Low-Sodium,Diet, Salt-Free,Diet, Low Salt,Diet, Low Sodium,Diet, Salt Free,Diet, Sodium Restricted,Diets, Low-Salt,Diets, Low-Sodium,Diets, Salt-Free,Diets, Sodium-Restricted,Low-Salt Diet,Low-Salt Diets,Low-Sodium Diet,Low-Sodium Diets,Salt-Free Diet,Salt-Free Diets,Sodium-Restricted Diet,Sodium-Restricted Diets