Geriatric Nutritional Risk Index evaluated at hospital discharge was independently associated with all-cause mortality (aHR 1.06 per 1 unit decrease; 95% CI 1.04-1.09; p<0.001), unlike at admission.
Cohort (n=1,474)
Yes
Does evaluating the Geriatric Nutritional Risk Index (GNRI) at hospital discharge predict long-term survival better than at hospital admission in patients with acute decompensated heart failure?
Evaluating the Geriatric Nutritional Risk Index at hospital discharge is a significantly better predictor of long-term mortality than evaluation at admission in patients with acute decompensated heart failure.
Effect estimate: aHR 1.06 (95% CI 1.04-1.09)
p-value: p=< 0.001
Geriatric Nutritional Risk Index (GNRI) is known both as a reliable indicator of nutritional status and a predictor of long-term survival among patients with acute decompensated heart failure (ADHF). However, the optimal timing to evaluate GNRI during hospitalization remains unclear. In the present study, we retrospectively analyzed patients hospitalized with ADHF in the West Tokyo Heart Failure (WET-HF) registry. GNRI was assessed at hospital admission (a-GNRI) and discharge (d-GNRI). Out of 1474 patients included in the present study, 568 (40.1%) and 796 (57.2%) patients had lower GNRI (<92) at hospital admission and discharge, respectively. After the follow-up (median 616 days), 290 patients died. The multivariable analysis showed that all-cause mortality was independently associated with d-GNRI (per 1 unit decrease, adjusted hazard ratio aHR: 1.06, 95% confidence interval CI: 1.04–1.09, p < 0.001), but not with a-GNRI (aHR: 0.99, 95% CI: 0.97–1.01, p = 0.341). The predictability of GNRI for long-term survival was more pronounced when evaluated at hospital discharge than at hospital admission (area under the curve 0.699 vs. 0.629, DeLong’s test p < 0.001). Our study suggested that GNRI should be evaluated at hospital discharge, regardless of the assessment at hospital admission, to predict the long-term prognosis for patients hospitalized with ADHF.
Ono et al. (Mon,) conducted a cohort in Acute decompensated heart failure (ADHF) (n=1,474). Geriatric Nutritional Risk Index (GNRI) at hospital discharge vs. GNRI at hospital admission was evaluated on all-cause mortality (aHR 1.06, 95% CI 1.04-1.09, p=< 0.001). Geriatric Nutritional Risk Index evaluated at hospital discharge was independently associated with all-cause mortality (aHR 1.06 per 1 unit decrease; 95% CI 1.04-1.09; p<0.001), unlike at admission.