scholarly journals Prognostic Impact of Change in Nutritional Risk on Mortality and Heart Failure After Transcatheter Aortic Valve Replacement

2021 ◽  
Vol 14 (2) ◽  
Author(s):  
Rocío González Ferreiro ◽  
Diego López Otero ◽  
Leyre Álvarez Rodríguez ◽  
Óscar Otero García ◽  
Marta Pérez Poza ◽  
...  
Keyword(s):  
Heart Failure ◽  
Transcatheter Aortic Valve Replacement ◽  
Risk Index ◽  
Nutritional Risk ◽  
Prognostic Impact ◽  
Geriatric Nutritional Risk Index ◽  
Transcatheter Aortic Valve ◽  
Risk Of Mortality ◽  
Nutritional Risk Index

Background: Limited data are available regarding change in the nutritional status after transcatheter aortic valve replacement (TAVR). This study evaluated the prognostic impact of the change in the geriatric nutritional risk index following TAVR. Methods: TAVR patients were analyzed in a prospective and observational study. To analyze the change in nutritional status, geriatric nutritional risk index of the patients was calculated on the day of TAVR and at 3-month follow-up. The impact of the change in nutritional risk index after TAVR on all-cause mortality, heart failure hospitalization (HF-h), and the composite of all-cause death and HF hospitalization was analyzed using the Cox Proportional Hazards model. Results: Four hundred thirty-three patients were included. After TAVR, 68.4% (n=182) patients with baseline nutritional risk improved compared with 31.6% (n=84) who remained at nutritional risk. The change from no-nutritional risk to nutritional risk after TAVR occurred in 15.0% (n=25), while 85.0% (n=142) remained without risk of malnutrition. During follow-up, 157 (36.3%) patients died and 172 patients (39.7%) were hospitalized due to HF. Patients who continued to be at nutritional risk had a higher risk of mortality (hazard ratio [HR], 2.10 [95% CI, 1.30–3.39], P =0.002), HF-h (HR, 1.97 [95% CI, 1.26–3.06], P =0.000), and the composite of death and HF-h (HR, 2.0 [95% CI, 1.37–2.91], P <0.001). The change to non-nutritional risk after TAVR significantly impacted mortality (HR, 0.48 [95% CI, 0.30–0.78], P =0.003), HF-h (HR, 0.50 [95% CI, 0.34–0.74], P =0.001), and the composite outcome (HR, 0.44 [95% CI, 0.32–0.62], P <0.001). Conclusions: Remaining at nutritional risk after TAVR confers a poor prognosis and is associated with an increased risk of mortality and HF-h, while the change from risk of malnutrition to non-nutritional risk after TAVR was associated with a halving of the risk of mortality and HF-h. Further studies are needed to identify whether patients at nutritional risk would benefit from nutritional intervention during processes of care of TAVR programs.

PROGNOSTIC IMPACT OF GERIATRIC NUTRITIONAL RISK INDEX IN ELDERLY PATIENTS WITH HEART FAILURE

2019 ◽  
Vol 73 (9) ◽  
pp. 1807
Author(s):  
Takahiro Okano ◽  
Hirohiko Motoki ◽  
Masatoshi Minamisawa ◽  
Kazuhiro Kimura ◽  
Soichiro Ebisawa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Elderly Patients ◽  
Risk Index ◽  
Nutritional Risk ◽  
Prognostic Impact ◽  
Geriatric Nutritional Risk Index ◽  
Nutritional Risk Index ◽  
Patients With Heart Failure

scholarly journals Prognostic impact of malnutrition assessed using geriatric nutritional risk index in patients aged ⩾80 years with heart failure

2019 ◽  
Vol 19 (2) ◽  
pp. 172-177 ◽  
Author(s):  
Tomohiro Nakamura ◽  
Mitsunari Matsumoto ◽  
Yumiko Haraguchi ◽  
Takeshi Ishida ◽  
Shin-ichi Momomura
Keyword(s):  
Heart Failure ◽  
Elderly Patients ◽  
Risk Index ◽  
Cox Proportional Hazards ◽  
Nutritional Risk ◽  
Prognostic Impact ◽  
Geriatric Nutritional Risk Index ◽  
Index Group ◽  
Nutritional Risk Index ◽  
The Mean

Aims: Malnutrition in elderly patients is one of the important issues in an aging society. We aimed to investigate the prevalence and prognostic impact of malnutrition assessed using the geriatric nutritional risk index in very elderly patients hospitalized owing to heart failure. Methods: We enrolled 213 consecutive patients aged ⩾80 years who were hospitalized with heart failure. The mean age was 87.2 ± 4.9 years, and 43.7% of them were male. The nutritional status on admission was evaluated using the geriatric nutritional risk index, which was calculated as follows: 14.89 × serum albumin (g/dL) + 41.7 × body mass index/22. The patients were divided into two groups, a low geriatric nutritional risk index group (<92) with malnutrition risk and a high geriatric nutritional risk index group (⩾92) without malnutrition risk. Results: The mean geriatric nutritional risk index of all patients was 90.7 ± 10.6, and 108 patients (50.7%) had low geriatric nutritional risk index. During the 540-day follow-up, the all-cause mortality was significantly higher in the low geriatric nutritional risk index group than in the high geriatric nutritional risk index group (35.7% vs. 12.9%, p < 0.001). The Cox proportional-hazards regression analysis revealed that low geriatric nutritional risk index was an independent predictor of mortality (hazard ratio, 2.28; 95% confidence interval, 1.15–4.49; p = 0.02). Conclusions: Low geriatric nutritional risk index on admission was common and was associated with poor prognosis in patients aged ⩾80 years who were hospitalized owing to heart failure.

scholarly journals Prognostic value of change in nutritional status after transcatheter aortic valve replacement

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Lopez Otero ◽  
R Gonzalez Ferreiro ◽  
J Lopez Pais ◽  
L Alvarez Rodriguez ◽  
P Antunez Muinos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Nutritional Status ◽  
Transcatheter Aortic Valve Replacement ◽  
Nutritional Risk ◽  
Heart Failure Hospitalization ◽  
Transcatheter Aortic Valve ◽  
Risk Of Mortality ◽  
Long Term Follow Up

Abstract Introduction and purpose Risk of malnutrition is a frequent condition among patients undergoing transcatheter aortic valve replacement (TAVR). Nutritional status assessed by nutritional risk index (NRI) is independently associated with an increased risk of death during long-term follow-up in these patients. The aim of the study is to determine the prognostic impact of the variation in nutritional risk after TAVR. Methods TAVR patients were included in an observational and prospective study between 2008–2019. Baseline and 3-months post-TAVR NRI were calculated as 1.519 x albumin (g/L) + 41.7 x (real weight [kg]/ideal weight [kg]). According to this parameter, the risk of malnutrition was severe (NRI&lt;83.5), moderate (83.5≥NRI&lt;97.5) and mild (97.5≥NRI&lt;100). We analyzed the change in nutritional status after TAVR and the association between nutritional status variation and the clinical outcomes: all-cause mortality, heart failure hospitalization and the composite of all-cause death and/or heart failure hospitalization at 3 years follow-up using the Cox proportional hazards model. Results 433 patients were included. 68.4% of patients with baseline nutritional risk had no nutritional risk after TAVR. The prevalence of risk of malnutrition was reduced to 25.2% after TAVR. During the follow-up (2.7±2.0 years), 157 (36.3%) patients died and 172 patients (39.7%) had heart failure hospitalization. Patients who remained at nutritional risk after TAVR had a higher risk of mortality (HR: 2.10 [95% CI: 1.30 to 3.39], p=0.002), heart failure hospitalization (HR: 1.97 [95% CI: 1.26 to 3.06], p=0.000) and the composite outcome (HR: 2.0 [95% CI: 1.37 to 2.91], p&lt;0.001). Conclusions Risk of malnutrition was a frequent condition among TAVR patients, but most patients improved their nutritional status after the procedure. The change in nutritional status is associated with prognosis: post-TAVR nutritional risk improvement is associated with reduced heart failure hospitalization, and the change to non-nutritional risk after TAVR halved the risk of mortality and heart failure hospitalization during long-term follow-up. Persistent nutritional risk after TAVR was related to poor prognosis. Further studies are needed to identify whether at nutritional risk would benefit from nutritional intervention during processes of care of TAVR programs. Change in NRI and prognostic value Funding Acknowledgement Type of funding source: None

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