Key result
Lower Geriatric Nutritional Risk Index (GNRI) scores were associated with significantly higher 1-year mortality after TAVI (50.01% vs 4.4%, P<0.001; HR 0.898, P<0.05).
Why the study?
Although the prognostic value of objective nutritional indexes has been shown in many diseases, their prognostic value in patients undergoing TAVI required evaluation.
Do objective nutritional indexes (GNRI, PNI, CONUT) predict 1-year mortality in patients undergoing TAVI?
Cohort (n=119)
Do objective nutritional indexes (GNRI, PNI, CONUT) predict 1-year mortality in patients undergoing TAVI?
Hazard Ratio: 0.898
Absolute Event Rate: 50.01% vs 4.4%
p-value: p=< .05
The Geriatric Nutritional Risk Index (GNRI) is a strong independent predictor of 1-year mortality in patients undergoing TAVI, outperforming other nutritional scores.
GNRI may aid TAVI risk stratification; hypothesis-generating for nutritional interventions, should not yet change practice.
Introduction The prognostic value of objective nutritional indexes has been demonstrated in many diseases. This study evaluated the prognostic value of these indexes in patients who underwent transcatheter aortic valve replacement (TAVI).Material and methods Totally, 119 consecutive patients who underwent TAVI between January 2016 and December 2018 were evaluated. All patients were followed-up for one year. Objective nutritional index (geriatric nutritional risk index [GNRI], prognostic nutritional index [PNI]) and controlling nutritional status [CONUT]) scores were calculated before TAVI.Results Mean age of the study population was 77.1 ± 7.8 years (59.7% female). During one-year follow-up, 31 (26.1%) deaths were observed. In a Kaplan–Meier analysis, mortality rates were significantly increased in patients with lower GNRI and PNI and higher CONUT scores (50.01% vs. 4.4%; p < .001, 48.1% vs. 15.2%; p < .001, 57.5% vs. 12.8%; p < .001, respectively). Pairwise comparisons of the ROC curves demonstrated that the GNRI score was a significantly better predictor of mortality than the PNI and CONUT scores (area under curve; 0.898, 0.664, and 0.722, respectively, for both; p < .001). According to Cox proportional hazard analyses, the GNRI (hazard ratio [HR]: 0.898) and STS (HR: 1.359) score were independently associated with increased 1-year mortality (for all p < .05).Conclusion The GNRI, PNI and CONUT scores were associated with 1-year all-cause mortality in patients who underwent TAVI. The predictive value of the GNRI score was significantly better than the PNI or CONUT scores. Assessment of the GNRI should be considered before TAVI.
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Küçükosmanoğlu et al. (2020) conducted a cohort in Transcatheter aortic valve replacement (TAVI) (n=119). Objective nutritional indexes (GNRI, PNI, CONUT) vs. Higher GNRI/PNI and lower CONUT scores was evaluated on 1-year mortality (HR 0.898, p=< .05). Lower Geriatric Nutritional Risk Index (GNRI) scores were associated with significantly higher 1-year mortality after TAVI (50.01% vs 4.4%, P<0.001; HR 0.898, P<0.05).
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