Patients with moderate-to-severe heart failure tend to have greater caloric needs than healthy adults, with needs increasing with symptom severity. They are at risk for being undernourished and may have weight loss.
Patients:
(1) 40 men aged 57-85 with 17 Blacks and 23 Whites
(2) New York Heart Association Class III or IV Heart Failure
resting metabolic rate in kcal per day =
= (12.2 * (weight in kilograms)) + (1.6 * (fasting glucose in g/dL)) + (103 * (NYHA classification)) - (144 * (serum albumin in g/dL)) + 755
where:
• NYHA = New York Heart Association. It appears that the equation is only used for NYHA class 3 or 4 patients, and that the grade number is used for the equation.
• Albumin in the reference is given as "mg/dL", but the data in Table 1 corresponds to the normal reference range for albumin in g/dL. Use of mg/dL in the equation would result in very high estimates for the metabolic rate.
• No correction for edema appears to be given for body weight.
• Root mean square error for the equation was 130 kcal (544 kJ) per day.
Interpretation:
• Equations used to predict resting metabolic needs in healthy adults tend to underestimate the metabolic rate in older males with heart failure.
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