This scoping review identifies nine categories of biopsychosocial factors influencing malnutrition in heart failure, providing a foundation for comprehensive nutritional risk assessment.
Background: Heart failure is characterized by high rates of hospitalization, substantial medical expenses and increased mortality, posing a serious threat to human health. Malnutrition is a common complication among patients with heart failure and is associated with increased risks of infection, rehospitalization and mortality, resulting in a considerable disease burden and financial strain on both patients and their families. Identifying patient-related influencing factors is the primary prerequisite for recognizing the risk of malnutrition. Objective: This scoping review aims to systematically summarize the factors influencing malnutrition in patients with heart failure, based on evidence from both domestic and international studies. Methods: Studies on malnutrition in heart failure were retrieved from PubMed, Web of Science, Cochrane Library, CINAHL, CNKI and Wanfang, from database inception to 25 May 2025. Two researchers independently screened titles and abstracts and extracted data according to predefined criteria. Findings were categorized and reported descriptively. Results: A total of 30 studies were included. The reported prevalence of malnutrition in heart failure varied by assessment tool. Based on the biopsychosocial model, nine categories of influencing factors were identified: demographic characteristics, disease characteristics, clinical physiological indicators, pharmacological treatment, emotional status, cognitive function, behavior, support system and living environment. Conclusion: This scoping review provides the first comprehensive summary of malnutrition-related factors in patients with heart failure through the biopsychosocial model. The findings indicate that malnutrition in patients with heart failure is affected by both subjective and objective factors and is closely associated with disease progression. A comprehensive understanding of the influencing factors of malnutrition contributes to the development of more precise nutritional risk assessment tools and lays the foundation for a continuous management pathway of screening, assessment, intervention, and monitoring to facilitate early risk identification.
Liu et al. (Mon,) studied this question.