{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T21:16:38Z","timestamp":1776978998841,"version":"3.51.4"},"reference-count":36,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Malnutrition is common among patients with advanced chronic illnesses receiving palliative care, yet comparative data between diagnostic groups are limited. This study aimed to evaluate and compare the nutritional status of patients with end-stage chronic heart failure (CHF) and chronic respiratory disease (CRD), and to assess the clinical utility of the Controlling Nutritional Status (CONUT) score in this setting. Methods: We conducted a retrospective analysis of 80 patients (41 with CHF, 39 with CRD) enrolled in a palliative care program (mean age 77.8 \u00b1 6.8 years, 65% male). Nutritional status was assessed using BMI (Body Mass Index), CONUT score, and routine biochemical markers. Functional and clinical variables, including the Palliative Performance Scale (PPS), were also collected. Results: Moderate-to-severe malnutrition (CONUT \u2265 5) was significantly more prevalent in patients with CHF patients (44%) than CRD patients (10%, p = 0.002). CHF patients exhibited lower BMI, cholesterol, lymphocyte counts, and prealbumin levels. Despite more frequent nutritional follow-up and protein supplementation in the CHF group, these interventions were not associated with improved nutritional classification. The CONUT score correlated more strongly with functional impairment (PPS) than with disease type alone. Conclusions: Patients with CHF receiving palliative care demonstrate higher rates of malnutrition than those with CRD. The CONUT score, derived from standard blood test, may be pragmatic screening tool for identifying nutritional vulnerability and guiding interventions. While it does not predict survival, it may help detect functional decline earlier and support care strategies aimed at maintaining quality of life in end-stage disease.<\/jats:p>","DOI":"10.3390\/nu17193040","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T09:43:12Z","timestamp":1758706992000},"page":"3040","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Nutritional Vulnerability and Functional Decline in End-Stage Heart Failure and Chronic Respiratory Disease: Utility of the CONUT Score in a Palliative Cohort"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5553-3216","authenticated-orcid":false,"given":"Martina","family":"Pellic\u00e9","sequence":"first","affiliation":[{"name":"Geriatric Department, Hospital Clinic of Barcelona, School of Medicine, University of Barcelona, Villarroel Street 170, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Ladino","sequence":"additional","affiliation":[{"name":"Geriatric Department, Hospital Clinic of Barcelona, School of Medicine, University of Barcelona, Villarroel Street 170, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0762-306X","authenticated-orcid":false,"given":"Karla Bel\u00e9n","family":"Trevi\u00f1o-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, University Hospital Dr. Jose Eleuterio Gonz\u00e1lez, Universidad Aut\u00f3noma de Nuevo Le\u00f3n, Monterrey 64460, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Su\u00e1rez-Lombra\u00f1a","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital Clinic of Barcelona, School of Medicine, University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7693-6591","authenticated-orcid":false,"given":"Marta","family":"Arroyo-Huidobro","sequence":"additional","affiliation":[{"name":"Geriatric Department, Hospital Clinic of Barcelona, School of Medicine, University of Barcelona, Villarroel Street 170, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5597-728X","authenticated-orcid":false,"given":"Aina","family":"Capdevila-Reniu","sequence":"additional","affiliation":[{"name":"Geriatric Department, Hospital Clinic of Barcelona, School of Medicine, University of Barcelona, Villarroel Street 170, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan David","family":"Solari","sequence":"additional","affiliation":[{"name":"Geriatric Department, Hospital Clinic of Barcelona, School of Medicine, University of Barcelona, Villarroel Street 170, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8018-1523","authenticated-orcid":false,"given":"Emilio","family":"Sacanella","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital Clinic of Barcelona, School of Medicine, University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Manuel","family":"Perez-Castejon","sequence":"additional","affiliation":[{"name":"Geriatric Department, Hospital Clinic of Barcelona, School of Medicine, University of Barcelona, Villarroel Street 170, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferran","family":"Masanes","sequence":"additional","affiliation":[{"name":"Geriatric Department, Hospital Clinic of Barcelona, School of Medicine, University of Barcelona, Villarroel Street 170, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1001\/jama.2020.15075","article-title":"Palliative Care for Patients with Noncancer Illnesses","volume":"324","author":"Harrison","year":"2020","journal-title":"JAMA J. Am. Med. Assoc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1056\/NEJMra1404684","article-title":"Palliative Care for the Seriously Ill","volume":"373","author":"Kelley","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Jang, H., Lee, K., Kim, S., and Kim, S. (2022). Unmet needs in palliative care for patients with common non-cancer diseases: A cross-sectional study. BMC Palliat. Care, 21.","DOI":"10.1186\/s12904-022-01040-0"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.clnu.2019.03.001","article-title":"Clinical outcome and cost-effectiveness of a 1-year nutritional intervention programme in COPD patients with low muscle mass: The randomized controlled NUTRAIN trial","volume":"39","author":"Rutten","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1002\/nur.21524","article-title":"Nutrition intervention to decrease symptoms in patients with advanced heart failure","volume":"36","author":"Lennie","year":"2013","journal-title":"Res. Nurs. Health"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.clnu.2018.08.002","article-title":"GLIM criteria for the diagnosis of malnutrition\u2013A consensus report from the global clinical nutrition community","volume":"38","author":"Cederholm","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3354","DOI":"10.1016\/j.clnu.2020.11.008","article-title":"Is there an association between the nutritional and functional parameters and congestive heart failure severity?","volume":"40","author":"Duarte","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1007\/s12603-017-0985-1","article-title":"The Role of Nutritional Status in Elderly Patients with Heart Failure","volume":"22","author":"Wleklik","year":"2018","journal-title":"J. Nutr. Health Aging"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.1002\/ejhf.3285","article-title":"Impact of malnutrition in patients with severe heart failure","volume":"26","author":"Pagnesi","year":"2024","journal-title":"Eur. J. Heart Fail."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s12937-021-00753-x","article-title":"Impact of nutritional status on heart failure mortality: A retrospective cohort study","volume":"21","author":"Carime","year":"2022","journal-title":"Nutr. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1136\/heartjnl-2018-313312","article-title":"Malnutrition, congestion and mortality in ambulatory patients with heart failure","volume":"105","author":"Sze","year":"2019","journal-title":"Heart"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1002\/jpen.2350","article-title":"Undernutrition is associated with mortality, exacerbation, and poorer quality of life in patients with chronic obstructive pulmonary disease: A systematic review with meta-analysis of observational studies","volume":"46","author":"Lima","year":"2022","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Kalu\u017aniak-Szymanowska, A., Krzymi\u0144ska-Siemaszko, R., Deskur-\u015bmielecka, E., Lewandowicz, M., Kaczmarek, B., and Wieczorowska-Tobis, K. (2022). Malnutrition, sarcopenia, and malnutrition-sarcopenia syndrome in older adults with COPD. Nutrients, 14.","DOI":"10.3390\/nu14010044"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S1332","DOI":"10.21037\/jtd.2018.02.66","article-title":"Nutritional status and muscle dysfunction in chronic respiratory diseases: Stable phase versus acute exacerbations","volume":"10","author":"Gea","year":"2018","journal-title":"J. Thorac. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.3390\/nu5041316","article-title":"Undernutrition in patients with COPD and its treatment","volume":"5","author":"Itoh","year":"2013","journal-title":"Nutrients"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2307","DOI":"10.1016\/j.jacc.2021.03.232","article-title":"Individualized Nutritional Support for Hospitalized Patients with Chronic Heart Failure","volume":"77","author":"Hersberger","year":"2021","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.jchf.2018.02.018","article-title":"Prevalence and Prognostic Significance of Malnutrition Using 3 Scoring Systems Among Outpatients with Heart Failure: A Comparison with Body Mass Index","volume":"6","author":"Sze","year":"2018","journal-title":"JACC Heart Fail."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Lo Buglio, A., Bellanti, F., Carmignano, D.F.P., Serviddio, G., and Vendemiale, G. (2024). Association between Controlling Nutritional Status (CONUT) Score and Body Composition, Inflammation and Frailty in Hospitalized Elderly Patients. Nutrients, 16.","DOI":"10.3390\/nu16050576"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Miano, N., Di Marco, M., Alaimo, S., Coppolino, G., L\u2019Episcopo, G., Leggio, S., Scicali, R., Piro, S., Purrello, F., and Di Pino, A. (2023). Controlling Nutritional Status (CONUT) Score as a Potential Prognostic Indicator of In-Hospital Mortality, Sepsis and Length of Stay in an Internal Medicine Department. Nutrients, 15.","DOI":"10.3390\/nu15071554"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Lo Buglio, A., Scioscia, G., Bellanti, F., Tondo, P., Soccio, P., Natale, M.P., Lacedonia, D., and Vendemiale, G. (2023). Controlling Nutritional Status Score as a Predictor for Chronic Obstructive Pulmonary Disease Exacerbation Risk in Elderly Patients. Metabolites, 13.","DOI":"10.3390\/metabo13111123"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.jjcc.2013.05.007","article-title":"The prognostic importance of objective nutritional indexes in patients with chronic heart failure","volume":"62","author":"Narumi","year":"2013","journal-title":"J. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1007\/s00380-017-1034-z","article-title":"The prognostic impact of malnutrition in patients with severely decompensated acute heart failure, as assessed using the Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) score","volume":"33","author":"Shirakabe","year":"2018","journal-title":"Heart Vessel."},{"key":"ref_23","first-page":"38","article-title":"CONUT: A tool for Controlling Nutritional Status. First validation in a hospital population","volume":"20","author":"Mancha","year":"2005","journal-title":"Nutr. Hosp."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Huang, X.W., Luo, J.J., and Baldinger, B. (2022). The controlling nutritional status score and clinical outcomes in patients with heart failure: Pool analysis of observational studies. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.961141"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1002\/ehf2.13255","article-title":"Sarcopenia in heart failure: A systematic review and meta-analysis","volume":"8","author":"Zhang","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1007\/s10741-019-09793-2","article-title":"Clinical significance of nutritional status in patients with chronic heart failure\u2014A systematic review","volume":"24","author":"Anaszewicz","year":"2019","journal-title":"Heart Fail. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.ahj.2007.11.043","article-title":"Albumin levels predict survival in patients with systolic heart failure","volume":"155","author":"Horwich","year":"2008","journal-title":"Am. Heart J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1093\/eurjhf\/hfr154","article-title":"Albumin levels predict survival in patients with heart failure and preserved ejection fraction","volume":"14","author":"Liu","year":"2012","journal-title":"Eur. J. Heart Fail."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1002\/ncp.11331","article-title":"Assessing nutrition risk and malnutrition rates in patients with chronic obstructive pulmonary disease: A cross-sectional study","volume":"40","year":"2025","journal-title":"Nutr. Clin. Pract."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"107774","DOI":"10.1016\/j.rmed.2024.107774","article-title":"Prevalence and prognostic value of malnutrition in patients with IPF using three scoring systems","volume":"233","author":"Shen","year":"2024","journal-title":"Respir. Med."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Tramontano, A., and Palange, P. (2023). Nutritional State and COPD: Effects on Dyspnoea and Exercise Tolerance. Nutrients, 15.","DOI":"10.3390\/nu15071786"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Faverio, P., Bocchino, M., Caminati, A., Fumagalli, A., Gasbarra, M., Iovino, P., Petruzzi, A., Scalfi, L., Sebastiani, A., and Stanziola, A.A. (2020). Nutrition in patients with idiopathic pulmonary fibrosis: Critical issues analysis and future research directions. Nutrients, 12.","DOI":"10.3390\/nu12041131"},{"key":"ref_33","first-page":"435","article-title":"Impact of nutritional status on body functioning in chronic obstructive pulmonary disease and how to intervene","volume":"11","author":"Aniwidyaningsih","year":"2008","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1007\/s12603-015-0536-6","article-title":"Evaluation of CONUT for Clinical Malnutrition Detection and Short-Term Prognostic Assessment in Hospitalized Elderly People","volume":"19","author":"Ferreiro","year":"2015","journal-title":"J. Nutr. Health Aging"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"E36018","DOI":"10.1097\/MD.0000000000036018","article-title":"Assessment of nutritional status and clinical outcomes: A comprehensive retrospective analysis of critically ill patients","volume":"102","author":"Koca","year":"2023","journal-title":"Medicine"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"5141","DOI":"10.1016\/j.clnu.2021.07.027","article-title":"Relevance of nutritional assessment and treatment to counteract cardiac cachexia and sarcopenia in chronic heart failure","volume":"40","author":"Castro","year":"2021","journal-title":"Clin. Nutr."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/19\/3040\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:48:43Z","timestamp":1760035723000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/19\/3040"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,24]]},"references-count":36,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["nu17193040"],"URL":"https:\/\/doi.org\/10.3390\/nu17193040","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,24]]}}}