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March 25, 2021Journal of Cachexia Sarcopenia and Muscle40 citationsOpen Access

Frailty in patients undergoing transcatheter aortic valve replacement: prognostic value of the Geriatric Nutritional Risk Index

HSHatim SeoudyBABaravan Al‐KassouJSJasmin Shamekhi

Key Result

Low Geriatric Nutritional Risk Index (GNRI < 98) was associated with a 44% higher risk of all-cause mortality in patients undergoing TAVR (HR 1.44, 95% CI 1.01–2.04).

Structured PICO

Does a low Geriatric Nutritional Risk Index (GNRI < 98) predict increased all-cause mortality in patients undergoing transcatheter aortic valve replacement?

P
Population
1,930 patients with symptomatic severe aortic stenosis undergoing transfemoral transcatheter aortic valve replacement (TAVR) across two cohorts (development n=953, validation n=977), median age 82.1 years, 54.6% female, based in Germany.
I
Intervention
Low Geriatric Nutritional Risk Index (GNRI < 98), indicating nutrition-related risk
C
Comparator
Normal Geriatric Nutritional Risk Index (GNRI ≥ 98), indicating no nutrition-related risk
O
Outcome
All-cause mortality at a mean follow-up of 21.1 months (development cohort) and 16.5 months (validation cohort)hard clinical

A low Geriatric Nutritional Risk Index (GNRI < 98) is an independent predictor of all-cause mortality in elderly patients undergoing TAVR, highlighting the importance of pre-procedural nutritional assessment.

Abstract

Abstract Background Malnutrition is a hallmark of frailty, is common among elderly patients, and is a predictor of poor outcomes in patients with severe symptomatic aortic stenosis (AS). The Geriatric Nutritional Risk Index (GNRI) is a simple and well‐established screening tool to predict the risk of morbidity and mortality in elderly patients. In this study, we evaluated whether GNRI may be used in the risk stratification and management of patients undergoing transcatheter aortic valve replacement (TAVR). Methods Patients with symptomatic severe AS ( n = 953) who underwent transfemoral TAVR at the University Hospital Schleswig‐Holstein Kiel, Germany, between 2010 and 2019 (development cohort) were divided into two groups: normal GNRI ≥ 98 (no nutrition‐related risk; n = 618) versus low GNRI 45.0 pg/mL), N ‐terminal pro‐B‐type natriuretic peptide in the highest quartile (> 3595 pg/mL), grade III–IV tricuspid regurgitation, pulmonary arterial hypertension, life‐threatening bleeding, AKIN Stage 3 and disabling stroke. Conclusions Low GNRI score was associated with an increased risk of all‐cause mortality in patients undergoing TAVR, implying that this vulnerable group may benefit from improved preventive measures.

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Cite This Study

Seoudy et al. (2021) studied this question. Low Geriatric Nutritional Risk Index (GNRI < 98) was associated with a 44% higher risk of all-cause mortality in patients undergoing TAVR (HR 1.44, 95% CI 1.01–2.04).

synapsesocial.com/papers/6967d5a8c59c9a05920964bahttps://doi.org/10.1002/jcsm.12689
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