Predicting Outcome in Patients With Left Ventricular Systolic Chronic Heart Failure Using a Nutritional Risk Index
Predicting Outcome in Patients With Left Ventricular Systolic Chronic Heart Failure Using a Nutritional Risk Index
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DOI：
10.1016/j.amjcard.2011.12.026
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发表时间：
2012-05-01
影响因子：
2.8
通讯作者：
Clark, Andrew L.
中科院分区：
文献类型：
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作者：
Al-Najjar, Yahya;Clark, Andrew L.
慢性心力衰竭（CHF）患者的死亡率较高，且与体重相关。然而，评估CHF患者营养状况的最佳方法尚不清楚。我们试图证明营养风险指数（NRI）在非卧床CHF患者中的预后用途。招募参加HF诊所第一次季度审查预约的连续性患者。所有患者均有收缩期左心室（LV）功能障碍。NRI计算为：（1.5 x血清白蛋白[克/升]）+（当前体重/理想体重）。患者每4个月随访一次。在入组研究的538名患者中，75%为男性。患者的年龄为71 ± 10岁（平均值± SD），存活者的总中位随访时间为68个月（四分位数范围54至74）。纽约心脏协会II级和III级分别占60%和27%，其中80%具有中度LV损伤或更严重。根据NRI，23%的患者有营养不良的风险。严重营养不良的患者年龄较大。NRI与左室功能无相关性。NRI是死亡率的单变量预测因子（卡方25，p
Mortality in patients with chronic heart failure (CHF) is high and associated with body mass. However, the best method of assessing nutritional status in patients with CHF is not clear. We sought to demonstrate the prognostic use of a nutritional risk index (NRI) in ambulatory patients with CHF. Consecutive patients attending their first quarterly review appointment in the HF clinic were recruited. All patients had systolic left ventricular (LV) dysfunction. An NRI was calculated as: (1.5 x serum albumin [grams per liter]) + (current body weight/ideal weight). Patients were followed up every 4 months. Of the 538 patients enrolled in the study 75% were men. The patients' age was 71 +/- 10 years (mean +/- SD) and total median follow-up in survivors was 68 months (interquartile range 54 to 74). New York Heart Association classes II and III accounted for 60% and 27%, respectively, with 80% having moderate LV impairment or worse. Based on the NRI 23% of patients were at risk of malnutrition. Severely malnourished patients were older. There was no relation between NRI and LV function. The NRI was a univariable predictor of mortality (chi-square 25, p