Key result
Nutritional scores fail to independently predict long-term mortality after TAVR.
Why the study?
This study aimed to comparatively evaluate the association between GNRI, PNI, and CONUT scores and long-term mortality in patients undergoing TAVR.
Do GNRI, PNI, and CONUT nutritional scores predict long-term mortality in patients undergoing transcatheter aortic valve replacement?
Observational (n=262)
No
Do GNRI, PNI, and CONUT nutritional scores predict long-term mortality in patients undergoing transcatheter aortic valve replacement?
Hazard Ratio: 0.979 (95% CI 0.954–1.004)
p-value: p=0.104
While malnutrition is highly prevalent and associated with worse survival in TAVR patients, GNRI, PNI, and CONUT scores do not provide independent prognostic value for long-term mortality beyond traditional clinical risk factors.
Nutritional scores lack independent prognostic value post-TAVR; leaves open whether they aid risk stratification or guide interventions.
Objective This study aimed to comparatively evaluate the association between geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), and controlling nutritional status (CONUT) scores and long-term mortality in patients undergoing transcatheter aortic valve replacement (TAVR). Method This retrospective observational study included 262 patients who underwent TAVR for severe symptomatic aortic stenosis between January 2015 and December 2018. Patients were divided into two groups based on all-cause mortality development during 7.6 years of follow-up: survivors and those who died. Nutritional status was assessed using pre-admission laboratory and anthropometric data, as well as GNRI, PNI, and CONUT scores. Results The mean age was 79.0 ± 6.4 years, and 45% of the patients were female. During the follow-up period, 106 patients (40.5%) died. Malnutrition prevalence was found to be 79.8% according to GNRI, 63.7% according to PNI, and 60.7% according to CONUT. In univariate analysis, GNRI (HR: 0.974, p = 0.035), PNI (HR: 0.959, p = 0.007), and CONUT (HR: 1.140, p < 0.001) were significantly associated with mortality. However, in multivariate analysis, none of these scores remained as independent predictors. In ROC analysis, AUC values for GNRI, CONUT, and PNI were found to be 0.626, 0.610, and 0.590, respectively. In Kaplan-Meier analysis, survival was lower in patients with poor nutritional status (log-rank p < 0.001). Conclusion In patients undergoing TAVR, impaired nutritional status is associated with long-term mortality; However, GNRI, PNI, and CONUT scores are not clinically independent predictors of mortality. These scores may provide complementary information regarding nutritional status but showed limited discriminatory ability for mortality prediction.
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Söner et al. (2026) conducted an observational in Severe symptomatic aortic stenosis undergoing TAVR (n=262). Impaired nutritional status (assessed by GNRI, PNI, and CONUT scores) vs. Normal nutritional status was evaluated on Long-term all-cause mortality (HR 0.979, 95% CI 0.954-1.004, p=0.104). Although impaired nutritional status was associated with long-term mortality in univariate analysis, GNRI, PNI, and CONUT scores did not remain independent predictors of mortality in patients undergoing TAVR after multivariable adjustment.
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