Nutritional risk screening in hospitalized patients with heart failure

Tevik, Kjerstin Elisabeth; Thürmer, Hanne; Husby, Marit Inderhaug; Soysa, Ann Kristin de; Helvik, Anne-Sofie

doi:10.1016/j.clnu.2014.03.014

Cited by 54 publications

(38 citation statements)

References 31 publications

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“…Malnutrition is associated with decreased immune system function, impaired respiratory function, and poor wound healing [12][13][14], as well as increased risks of postoperative morbidity and mortality and prolonged hospital stays [15,16]. Thus, nutritional status has been proven to be an independent prognostic factor and several nutritional screening tools, such as the Mini Nutritional Risk Screening and Nutritional Risk Screening, have been developed to assess nutritional risk in patients with specific diseases such as heart failure [17][18][19]. Prognostic models have been used to predict the survival of patients using nutritional status combined with biochemical nutritional indicators, such as total cholesterol, serum albumin, and total lymphocyte count.…”

Section: Introductionmentioning

confidence: 99%

Predictive Impact of Modified-Prognostic Nutritional Index for Acute Kidney Injury within 1-week after Living Donor Liver Transplantation

Min¹,

Woo²,

Chae³

et al. 2020

Int. J. Med. Sci.

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Background. Acute kidney injury (AKI) is one of the common complications after living donor liver transplantation (LDLT) and is associated with increased mortality and morbidity. The prognostic nutritional index (PNI) has been used as a predictive model for postoperative complications. Here, we create a new predictive model based on the PNI and compared its predictive accuracy to other models in patients who underwent LDLT. Material and Methods: The data from 423 patients were collected retrospectively. The patients were dichotomized into the non-AKI and the AKI groups. Multivariate adjustment for significant postoperative variables based on univariate analysis was performed. A new predictive model was created using the results from logistic regression analysis, dubbed the modified-PNI model (mPNI). The area under the receiver operating characteristic curve (AUC) was generated to determine the diagnostic accuracy and cutoff value of individual models. The net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were calculated to investigate diagnostic improvement by the mPNI. Results: Fifty-four patients (12.7 %) were diagnosed with AKI within 1-week after LDLT. The mPNI had the highest predictive accuracy (AUC = 0.823). The model of end-stage liver disease (MELD) scores and PNI were 0.793 and 0.749, respectively, and the INR and serum bilirubin were 0.705 and 0.637, respectively. The differences in the AUCs were statistically significant among the mPNI, PNI, INR, and serum bilirubin. The cutoff value for mPNI was 8.7. The NRI was 10.4% and the IDI was 3.3%. Conclusions: The mPNI predicted AKI within 1-week better than other scoring systems in patients who underwent LDLT. The recommended cutoff value of mPNI is 8.7.

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Section: Introductionmentioning

confidence: 99%

Predictive Impact of Modified-Prognostic Nutritional Index for Acute Kidney Injury within 1-week after Living Donor Liver Transplantation

Min¹,

Woo²,

Chae³

et al. 2020

Int. J. Med. Sci.

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“…8 When Anker et al and Zapatero et al demonstrated that nutritional status was an independent prognostic factor in patients with either acute or chronic HF, 8,9 several nutritional screening tools such as the Mini Nutritional Assessment-Short Form (MNA-SF) and Nutritional Risk Screening (NRS-2002) were developed for assessing nutritional risks in patients with HF. 10,11 Given the complexity of computing these indexes and the subjectivity of the questionnaires, the validity and the generalizability of the nutritional indexes and questionnaires may vary according to the experience of the examiners and the presence of recall bias from the patients.…”

mentioning

confidence: 99%

Prognostic Nutritional Index and the Risk of Mortality in Patients With Acute Heart Failure

Cheng

Sung

Cheng

et al. 2017

JAHA

213

208

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BackgroundNutritional status has been related to clinical outcomes in patients with heart failure. We assessed the association between nutritional status, indexed by prognostic nutritional index (PNI), and survival in patients hospitalized for acute heart failure.Methods and ResultsA total of 1673 patients (age 76±13 years, 68% men) hospitalized for acute heart failure in a tertiary medical center were analyzed. PNI was calculated as 10×serum albumin (g/dL)+0.005×total lymphocyte count (per mm3). National Death Registry was linked to identify the clinical outcomes of all‐cause and cardiovascular death. With increasing tertiles of PNI, age and N‐terminal probrain natriuretic peptide decreased, and body mass index, estimated glomerular filtration rate, and hemoglobin increased. During a mean follow‐up duration of 31.5 months, a higher PNI tertile was related to better survival free from all‐cause and cardiovascular mortality in the total study population and in participants with either reduced or preserved left ventricular ejection fraction. After accounting for age, sex, estimated glomerular filtration rate, left ventricular ejection fraction, serum sodium level, and on‐admission systolic blood pressure, PNI was independently associated with cardiovascular death and total mortality (hazard ratio per 1 SD of the natural logarithm of the PNI: 0.76 [95% CI, 0.66–0.87] and 0.79 [95% CI, 0.73–0.87], respectively). In subgroup analyses stratified by age, sex, left ventricular ejection fraction, body mass index, or estimated glomerular filtration rate, PNI was consistently related to mortality.Conclusions PNI is independently associated with long‐term survival in patients hospitalized for acute heart failure with either reduced or preserved left ventricular ejection fraction.

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“…These nutritional screening tools have been reported to be useful for predicting prognosis in conditions such as chronic kidney disease [17] and chronic heart failure [18]. To our knowledge, the present study is the first to report a relationship between nutritional screening results and prognosis of hospitalized patients with CD.…”

Section: Introductionmentioning

confidence: 61%

“…Furthermore, another report stated that SGA was an excellent predictor of outcome in patients undergoing liver transplantation [21]. Conversely, Tevik et al [18] found that the incidence of complications and the median LOS were significantly higher in patients with NRS 2002 scores ≥3, concluding that the NRS 2002 was a reliable screening tool in their sample of hospitalized patients with chronic heart failure. Moreover, multivariate analysis conducted by Tsaousi et al [22] highlighted limited autonomy in everyday activities, MUST score, and artificial nutrition as the most powerful predictors of pressure ulcers.…”

Section: Discussionmentioning

confidence: 99%

Nutritional Screening and Clinical Outcome in Hospitalized Patients with Crohn’s Disease

et al. 2017

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Background/Aims: Hospitalized patients with Crohn’s disease (CD) can develop severe nutritional deficits. However, the nutritional screening tools with the most utility for such patients are still unknown. Methods: Nutritional status of 40 CD patients was assessed on admission using several screening tools and laboratory tests. Their validity was evaluated in relation to length of hospital stay (LOS) and intestinal resection. Receiver operating characteristic analysis was performed to predict prolonged LOS (≥28 days). Results: Prolonged LOS was correlated with each of the following screening parameters: Subjective Global Assessment, Nutrition Risk Screening 2002 (NRS 2002), Onodera’s Prognostic Nutritional Index (O-PNI), Controlling Nutritional Status, serum albumin level, and weight loss. These parameters were not correlated with intestinal resection. Evaluation of prognostic yield showed cutoff values of serum albumin 3.3 g/dL (AUC 0.797, sensitivity 57.1%, specificity 89.5%) and O-PNI 36.5 (0.749, 71.4%, 73.7%). By combining the serum albumin cutoff value and NRS 2002 score, patients were divided into 4 groups, with a prolonged LOS rate of 68.2% in the group with the worst prognosis. Conclusions: A combination of serum albumin (given the simplicity of testing) and NRS 2002 as nutritional screening tools may be useful for hospitalized CD patients.

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Nutritional risk screening in hospitalized patients with heart failure

Cited by 54 publications

References 31 publications

Predictive Impact of Modified-Prognostic Nutritional Index for Acute Kidney Injury within 1-week after Living Donor Liver Transplantation

Predictive Impact of Modified-Prognostic Nutritional Index for Acute Kidney Injury within 1-week after Living Donor Liver Transplantation

Prognostic Nutritional Index and the Risk of Mortality in Patients With Acute Heart Failure

Nutritional Screening and Clinical Outcome in Hospitalized Patients with Crohn’s Disease

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