Geriatric nutritional risk index as a nutritional and survival risk assessment tool in stable outpatients with systolic heart failure

Sargento, Luís; Simões, Andre Vicente; Rodrigues, J.; Longo, Susana; Lousada, Nuno; Reis, Roberto Palma dos

doi:10.1016/j.numecd.2017.02.003

Cited by 41 publications

(37 citation statements)

References 16 publications

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“…Our results showed that all-cause death occurred more frequently in HFpEF patients with moderate or major nutrition-related risk than in those with low or no nutrition-related risk ( Table 3 and Model 4). [7][8][9][10][11][12][13][14][15][16][17][18][19][20] However, to our knowledge, all but one 18 of the previous studies reported on so-called HF patients, and therefore, our specific findings for 'HFpEF patients' are novel. The results of the present study indicate that screening nutritional status using a GNRI at discharge further refines risk assessment in patients hospitalized with HFpEF.…”

Section: Discussionmentioning

confidence: 75%

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Geriatric nutritional risk index predicts all‐cause deaths in heart failure with preserved ejection fraction

et al. 2019

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Aims The objective of the study was to evaluate whether the geriatric nutritional risk index (GNRI) at discharge may be helpful in predicting the long‐term prognosis of patients hospitalized with heart failure (HF) with preserved ejection fraction (HFpEF, left ventricular ejection fraction ≥50%), a common HF phenotype in the elderly. Methods and results Overall, 110 elderly HFpEF patients (≥65 years) from the Ibaraki Cardiovascular Assessment Study‐HF ( n = 838) were enrolled. The mean age was 78.5 ± 7.2 years, and male patients accounted for 53.6% ( n = 59). All‐cause mortality was compared between the low GNRI (<92) with moderate or severe nutritional risk group and the high GNRI (≥92) with no or low nutritional risk group. Cox proportional hazard regression models were constructed to evaluate the influence of the GNRI on all‐cause death with the following covariates using forward stepwise selection: age, sex, nutritional status based on the GNRI as a categorical variable, history of HF hospitalization, haemoglobin level, estimated glomerular filtration rate, log brain natriuretic peptide levels (logBNP), history of hypertension, log C‐reactive protein levels, left ventricular ejection fraction, left ventricular mass index, and the New York Heart Association functional classification (I/II or III class). The prognostic value of the GNRI was compared with that of serum albumin using C‐statistics. The GNRI was added to the logBNP, serum albumin or the body mass index was added to the logBNP, and the C‐statistic was compared using DeLong's test. Cox regression analysis revealed that age and a low GNRI were independent predictors of all‐cause death ( P < 0.05, n = 103; hazard ratio = 1.095, 95% confidence interval = 1.031–1.163, for age, and hazard ratio = 3.075, 95% confidence interval = 1.244–7.600, for the GNRI). DeLong's test for the two correlated receiver operating characteristic curves [area under the receiver operating characteristic curve (AUROC) of serum albumin, 0.71; AUROC of the GNRI, 0.75] demonstrated significant differences between the groups ( P = 0.038). Adding the GNRI to the logBNP increased the AUROC for all‐cause death significantly (0.71 and 0.80, respectively; P = 0.040, n = 105). The addition of serum albumin or the body mass index to the logBNP did not significantly increase the AUROC for all‐cause death ( P = 0.082 and P = 0.29, respectively). Conclusions Nutritional screening using the GNRI at discharge is helpful to predict the long‐term prognosis of elderly HFpEF patients.

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Section: Discussionmentioning

confidence: 75%

“…[7][8][9][10][11][12][13][14][15][16][17] The geriatric nutritional risk index (GNRI) is a simple and well-established nutritional screening tool for elderly HF patients. [18][19][20] However, the predictive value of the assessment of nutritional status using GNRI in patients with HFpEF remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Geriatric nutritional risk index predicts all‐cause deaths in heart failure with preserved ejection fraction

et al. 2019

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“…[1][2][3] The Geriatric Nutritional Risk Index (GNRI) was proposed by Bouillanne et al to evaluate nutritional disorders in older adults. [5][6][7][8][9][10] Sarcopenia is defined as an age-related involuntary loss of skeletal muscle mass and strength, and it results in physical disability, a poor quality of life and increased risk of death. [5][6][7][8][9][10] Sarcopenia is defined as an age-related involuntary loss of skeletal muscle mass and strength, and it results in physical disability, a poor quality of life and increased risk of death.…”

Section: Introductionmentioning

confidence: 99%

“…4 In recent years, the GNRI has been used to evaluate the nutritional condition of older adults, and an association between the GNRI and prognosis has been reported. [5][6][7][8][9][10] Sarcopenia is defined as an age-related involuntary loss of skeletal muscle mass and strength, and it results in physical disability, a poor quality of life and increased risk of death. 11,12 However, few studies have focused on the relationship between the GNRI and sarcopenia.…”

Section: Introductionmentioning

confidence: 99%

Geriatric Nutritional Risk Index for independent walking function in maintenance hemodialysis patients: A single‐facility retrospective cohort study

Tanaka¹,

Nishiyama

Yamamura

et al. 2018

Geriatrics Gerontology Int

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Aim The target Geriatric Nutritional Risk Index (GNRI) for patients on chronic maintenance hemodialysis is unclear. We aimed to determine the relationship between the GNRI and independent walking ability in such patients. Methods In the present retrospective cohort study, 90 patients receiving chronic maintenance hemodialysis were included. Logistic regression analyses were carried out to evaluate the relationship between the GNRI and independent walking ability. Receiver operating characteristic curve analysis was carried out to determine the cut‐off GNRI for predicting independent walking ability. Results Multivariate logistic regression analysis showed significant differences in age (odds ratio [OR] 0.8, 95% confidence interval [CI] 0.6–0.9), creatinine generation rate percentage (OR 1.1, 95% CI 1.0–1.2), GNRI (OR 1.4, 95% CI 1.1–1.8; P < 0.01) and urea removal rate (OR 0.3, 95% CI 0.1–0.9; P < 0.05). The cut‐off GNRI for independent walking ability was 86.7 (area under the curve 0.80, sensitivity 92.1%, specificity 66.7%, positive hit ratio 86.6%, negative hit ratio 78.3%). The factors correlated with survival in the univariate analysis were the GNRI, equilibrated Kt/V, urea removal rate, clear space rate, salt intake amount (P < 0.01), number of days of hospitalization and %creatinine generation rate (P < 0.05). The Cox proportional hazard regression model showed an OR of 0.77 (95% CI 0.32–1.8) at a GNRI <86/GNRI ≥86. In the multivariate survival analysis, we observed no significant differences in any of the factors. Conclusions GNRI was correlated with walking ability, which indicated that GNRI might predict future walking ability; also, a GNRI of 87 might be the target for maintaining walking ability. Geriatr Gerontol Int 2018; 18: 1556–1561.

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“…The GNRI was calculated as follows: 14.89 × serum albumin (g/dL) + 41.7 × body mass index / 22. In accordance with previous studies, patients were classified into the low or severe nutrition‐related risk (GNRI <98) or no nutrition‐related risk (GNRI ≥98) While comparing participants with low GNRI values and those with high GNRI, we used a cut‐off score of 98 to divide the two groups…”

Section: Methodsmentioning

confidence: 99%

Geriatric Nutritional Risk Index, a predictive assessment tool, for postoperative complications after abdominal surgery: A prospective multicenter cohort study

Hanada

Yamauchi

Miyazaki

et al. 2019

Geriatrics Gerontology Int

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Aim: Patients awaiting abdominal surgery are often malnourished, which puts them at a high risk of postoperative complications. The aim of the present study was to investigate the effects of preoperative nutritional status using the Geriatric Nutritional Risk Index (GNRI) on postoperative complications and the course of recovery for patients undergoing abdominal surgery.Methods: In this prospective multicenter cohort study, we enrolled patients awaiting abdominal surgery from November 2015 to December 2017. The characteristics of patients and postoperative complications were compared between participants (median age 71 years; interquartile range 66-78 years) with low GNRI (<98) values and high GNRI (≥98) values. Multivariate logistic regression was carried out to identify postoperative complications-related factors.Results: A total of 366 patients who underwent abdominal surgery were assessed. Patients in the low GNRI group had a significantly higher rate of postoperative complications (P = 0.01), and longer length of hospital stay compared with those in the high GNRI group (P < 0.01). Using multivariate analysis, low GNRI was found to be independently associated with postoperative complications (OR 2.50; P = 0.02) and activities of daily living on postoperative day 7 (OR 1.39; P = 0.03). Comorbidities, handgrip force for postoperative complications, age, preoperative chemotherapy and activities of daily living on postoperative day 7 were not independently associated. Conclusions: Malnutrition indicated by the GNRI might be predictive of postoperative complications after abdominal surgery and the delay of postoperative course. Geriatr Gerontol Int 2019; 19: 924-929.

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Geriatric nutritional risk index as a nutritional and survival risk assessment tool in stable outpatients with systolic heart failure

Cited by 41 publications

References 16 publications

Geriatric nutritional risk index predicts all‐cause deaths in heart failure with preserved ejection fraction

Geriatric nutritional risk index predicts all‐cause deaths in heart failure with preserved ejection fraction

Geriatric Nutritional Risk Index for independent walking function in maintenance hemodialysis patients: A single‐facility retrospective cohort study

Geriatric Nutritional Risk Index, a predictive assessment tool, for postoperative complications after abdominal surgery: A prospective multicenter cohort study

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