The impact of geriatric nutritional risk index on one-year outcomes in hospitalized elderly patients with heart failure
BackgroundStrategies that accurately predict outcomes in elderly heart failure (HF) patients have not been sufficiently established. In previous reports, nutritional status, ability to perform activities of daily living (ADL), and lower limb muscle strength are known prognostic factors associated wi...
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| Format: | Article |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1190548/full |
| _version_ | 1797814142055219200 |
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| author | Masakazu Miura Masakazu Miura Shinichi Okuda Kazuhiro Murata Yutaka Ohno Satoshi Katou Fumiaki Nakao Takeshi Ueyama Takeshi Yamamoto Yasuhiro Ikeda |
| author_facet | Masakazu Miura Masakazu Miura Shinichi Okuda Kazuhiro Murata Yutaka Ohno Satoshi Katou Fumiaki Nakao Takeshi Ueyama Takeshi Yamamoto Yasuhiro Ikeda |
| author_sort | Masakazu Miura |
| collection | DOAJ |
| description | BackgroundStrategies that accurately predict outcomes in elderly heart failure (HF) patients have not been sufficiently established. In previous reports, nutritional status, ability to perform activities of daily living (ADL), and lower limb muscle strength are known prognostic factors associated with cardiac rehabilitation (CR). In the present study, we investigated which CR factors can accurately predict one-year outcomes in elderly patients with HF among the above factors.MethodsHospitalized patients with HF over 65 years of age from January 2016 to January 2022 were retrospectively enrolled in the Yamaguchi Prefectural Grand Medical (YPGM) Center. They were consequently recruited to this single-center retrospective cohort study. Nutritional status, ADL, and lower limb muscle strength were assessed by geriatric nutritional risk index (GNRI), Barthel index (BI), and short physical performance battery (SPPB) at discharge, respectively. One year after discharge, the primary and secondary outcomes were evaluated by all-cause death or HF readmission and major adverse cardiac and cerebrovascular events (MACCE), respectively.ResultsOverall, 1,078 HF patients were admitted to YPGM Center. Of those, 839 (median age 84.0, 52% female) met the study criteria. During the follow-up of 228.0 days, 72 patients reached all-cause death (8%), 215 experienced HF readmission (23%), and 267 reached MACCE (30%: 25 HF death, six cardiac death, and 13 strokes). A multivariate Cox proportional hazard regression analysis revealed that the GNRI predicted the primary outcome (Hazard ratio [HR]: 0.957; 95% confidence interval [CI]: 0.934–0.980; p < 0.001) and the secondary outcome (HR: 0.963; 95%CI: 0.940–0.986; p = 0.002). Furthermore, a multiple logistic regression model using the GNRI most accurately predicted the primary and secondary outcomes compared to those with the SPPB or BI models.ConclusionA nutrition status model using GNRI provided a better predictive value than ADL ability or lower limb muscle strength. It should be recognized that HF patients with a low GNRI at discharge may have a poor prognosis at one year. |
| first_indexed | 2024-03-13T08:03:11Z |
| format | Article |
| id | doaj.art-5aa2ef90bf6a40268dc066757852115e |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-13T08:03:11Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-5aa2ef90bf6a40268dc066757852115e2023-06-01T10:14:09ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-05-011010.3389/fcvm.2023.11905481190548The impact of geriatric nutritional risk index on one-year outcomes in hospitalized elderly patients with heart failureMasakazu Miura0Masakazu Miura1Shinichi Okuda2Kazuhiro Murata3Yutaka Ohno4Satoshi Katou5Fumiaki Nakao6Takeshi Ueyama7Takeshi Yamamoto8Yasuhiro Ikeda9Department of Rehabilitation, Yamaguchi Prefectural Grand Medical Center, Hofu, JapanDivision of Nursing and Laboratory Science, Yamaguchi University Graduate School of Medicine, Ube, JapanDepartment of Cardiology, Yamaguchi Prefectural Grand Medical Center, Hofu, JapanDepartment of Rehabilitation, Yamaguchi Prefectural Grand Medical Center, Hofu, JapanDepartment of Rehabilitation, Yamaguchi Prefectural Grand Medical Center, Hofu, JapanDepartment of Rehabilitation, Yamaguchi Prefectural Grand Medical Center, Hofu, JapanDepartment of Cardiology, Yamaguchi Prefectural Grand Medical Center, Hofu, JapanDepartment of Cardiology, Yamaguchi Prefectural Grand Medical Center, Hofu, JapanDivision of Nursing and Laboratory Science, Yamaguchi University Graduate School of Medicine, Ube, JapanDepartment of Cardiology, Yamaguchi Prefectural Grand Medical Center, Hofu, JapanBackgroundStrategies that accurately predict outcomes in elderly heart failure (HF) patients have not been sufficiently established. In previous reports, nutritional status, ability to perform activities of daily living (ADL), and lower limb muscle strength are known prognostic factors associated with cardiac rehabilitation (CR). In the present study, we investigated which CR factors can accurately predict one-year outcomes in elderly patients with HF among the above factors.MethodsHospitalized patients with HF over 65 years of age from January 2016 to January 2022 were retrospectively enrolled in the Yamaguchi Prefectural Grand Medical (YPGM) Center. They were consequently recruited to this single-center retrospective cohort study. Nutritional status, ADL, and lower limb muscle strength were assessed by geriatric nutritional risk index (GNRI), Barthel index (BI), and short physical performance battery (SPPB) at discharge, respectively. One year after discharge, the primary and secondary outcomes were evaluated by all-cause death or HF readmission and major adverse cardiac and cerebrovascular events (MACCE), respectively.ResultsOverall, 1,078 HF patients were admitted to YPGM Center. Of those, 839 (median age 84.0, 52% female) met the study criteria. During the follow-up of 228.0 days, 72 patients reached all-cause death (8%), 215 experienced HF readmission (23%), and 267 reached MACCE (30%: 25 HF death, six cardiac death, and 13 strokes). A multivariate Cox proportional hazard regression analysis revealed that the GNRI predicted the primary outcome (Hazard ratio [HR]: 0.957; 95% confidence interval [CI]: 0.934–0.980; p < 0.001) and the secondary outcome (HR: 0.963; 95%CI: 0.940–0.986; p = 0.002). Furthermore, a multiple logistic regression model using the GNRI most accurately predicted the primary and secondary outcomes compared to those with the SPPB or BI models.ConclusionA nutrition status model using GNRI provided a better predictive value than ADL ability or lower limb muscle strength. It should be recognized that HF patients with a low GNRI at discharge may have a poor prognosis at one year.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1190548/fullheart failuregeriatric nutritional risk index (GNRI)short performance physical batterybarthel index (BI)cardiac rehabilitation (CR) |
| spellingShingle | Masakazu Miura Masakazu Miura Shinichi Okuda Kazuhiro Murata Yutaka Ohno Satoshi Katou Fumiaki Nakao Takeshi Ueyama Takeshi Yamamoto Yasuhiro Ikeda The impact of geriatric nutritional risk index on one-year outcomes in hospitalized elderly patients with heart failure Frontiers in Cardiovascular Medicine heart failure geriatric nutritional risk index (GNRI) short performance physical battery barthel index (BI) cardiac rehabilitation (CR) |
| title | The impact of geriatric nutritional risk index on one-year outcomes in hospitalized elderly patients with heart failure |
| title_full | The impact of geriatric nutritional risk index on one-year outcomes in hospitalized elderly patients with heart failure |
| title_fullStr | The impact of geriatric nutritional risk index on one-year outcomes in hospitalized elderly patients with heart failure |
| title_full_unstemmed | The impact of geriatric nutritional risk index on one-year outcomes in hospitalized elderly patients with heart failure |
| title_short | The impact of geriatric nutritional risk index on one-year outcomes in hospitalized elderly patients with heart failure |
| title_sort | impact of geriatric nutritional risk index on one year outcomes in hospitalized elderly patients with heart failure |
| topic | heart failure geriatric nutritional risk index (GNRI) short performance physical battery barthel index (BI) cardiac rehabilitation (CR) |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1190548/full |
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