Correlation between the prognostic nutritional index and outcomes in older patients aged ≥ 60 years with chronic heart failure
Correlation between the prognostic nutritional index and outcomes in older patients aged ≥ 60 years with chronic heart failure
复制标题
DOI：
10.1007/s11096-022-01501-9
复制
发表时间：
2022-11
影响因子：
2.4
通讯作者：
Chenlin Zhuang;Yudai Chen;Junshan Ruan;Huizhen Yu;Pengli Zhu;Yizhun Zhu
中科院分区：
文献类型：
--
作者：
Chenlin Zhuang;Yudai Chen;Junshan Ruan;Huizhen Yu;Pengli Zhu;Yizhun Zhu
研究背景慢性心力衰竭（CHF）患者的营养状况与其临床结局有关.预后营养指数（PNI）是一个简单的工具，以评估nutrition.AimTo评估PNI评分和临床结果之间的关联在患者（60岁及以上）住院治疗，由于急性加重的CHF.MethodThis是一项回顾性观察研究。分析了2015年7月至2020年5月期间因急性CHF加重住院的患者。患者随访至2021年1月31日。主要终点是出院后心血管相关再入院和全因死亡率。次要结局是与全因死亡率相关的因素。根据营养状况分为正常营养组（PNI > 38）、中度营养组（PNI = 35-38）和重度营养组（PNI < 35）。中位随访时间为769天。与存活者（n = 214）相比，死亡患者（n = 133）：（1）年龄较大;（2）PNI评分、淋巴细胞计数、血红蛋白、白蛋白、总胆固醇和血清钠水平较低;但（3）血清肌酐水平、log（N末端B型利钠肽原）和心肌肌钙蛋白I较高（P< 0.05）。多变量分析显示PNI与全因死亡率独立相关。中度营养不良与正常营养的风险比（HR）为1.624（95%可信区间[CI] 1.011- 2.609，P = 0.045），而重度营养不良与正常营养的HR为1.892（95%CI 1.119- 3.198，P = 0.017）。营养不良的患者有显着较高的心血管再入院率和全因mortals.ConclusionLower PNI（营养不良）与不良的临床结局，并与CHF患者的全因死亡率独立相关。
BackgroundNutritional status is related to clinical outcomes in patients with chronic heart failure (CHF). The prognostic nutritional index (PNI) is a simple tool to assess nutrition.AimTo evaluate the association between the PNI score and clinical outcomes in patients (60 years and older) hospitalized due to an acute exacerbation of CHF.MethodThis was a retrospective observational study. Patients hospitalized for acute CHF exacerbation between July 2015 and May 2020 were analyzed. Patients were followed until January 31, 2021. The primary end point was cardiovascular-related readmissions and all-cause mortality after hospital discharge. Secondary outcomes were factors associated with all-cause mortality. Patients were divided into normal nutrition (PNI > 38), moderate malnutrition (PNI = 35–38), and severe malnutrition (PNI < 35) groups.ResultsThe study included 355 patients (mean age 78 ± 9 years). The median follow-up was 769 days. Compared to survivors (n = 214), patients who expired (n = 133) were (1) older; (2) had lower PNI scores, lymphocyte counts, hemoglobin, albumin, total cholesterol, and serum sodium level; but (3) had higher serum creatinine levels, log(N-terminal-pro-B-type natriuretic peptide), and cardiac troponin I (P< 0.05). Multivariate analyses revealed that PNI was independently associated with all-cause mortality. The hazard ratio (HR) for moderate malnutrition versus normal nutrition was 1.624 (95% confidence interval [CI] 1.011–2.609,P= 0.045), while HR for severe malnutrition versus normal nutrition was 1.892 (95%CI 1.119–3.198,P= 0.017). Malnourished patients had significantly higher rates of cardiovascular readmissions and all-cause mortality.ConclusionLower PNI (malnutrition) was associated with worse clinical outcomes and was independently associated with all-cause mortality in patients with CHF.