Geriatric Nutritional Risk Index Predicts Functional Dependency and Mortality in Patients With Heart Failure With Preserved Ejection Fraction

• Published in: Circulation Journal Vol. 77; no. 3; pp. 705 - 711
• Main Authors: Kinugasa, Yoshiharu, Kato, Masahiko, Sugihara, Shinobu, Hirai, Masayuki, Yamada, Kensaku, Yanagihara, Kiyotaka, Yamamoto, Kazuhiro
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 2013
• Subjects: Activities of Daily Living; Aged; Aged, 80 and over; Blood Urea Nitrogen; Body mass index; C-Reactive Protein - metabolism; Female; Follow-Up Studies; Geriatric Assessment; Geriatric nutritional risk index; Heart Failure - blood; Heart Failure - mortality; Heart Failure - physiopathology; Heart failure with preserved ejection fraction; Hemoglobins - metabolism; Humans; Hypoalbuminemia; Male; Natriuretic Peptide, Brain - blood; Nutrition Assessment; Predictive Value of Tests; Retrospective Studies; Risk Assessment; Sex Factors; Stroke Volume - physiology; Survival Rate
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-12-1091

Background: The clinical significance of nutritional risk assessment in patients with heart failure with preserved ejection fraction (HFpEF) remains undefined. Geriatric nutritional risk index (GNRI) is a simple nutritional assessment tool for elderly subjects. Its predictive value was evaluated in patients with HFpEF, a common HF phenotype in the elderly population. Methods and Results: The present study enrolled 152 consecutive patients (mean age, 77±11 years; male, 53.9%) who were hospitalized with HFpEF at the authors’ institution. GNRI on admission was calculated as follows: 14.89×serum albumin (g/dl)+41.7×body mass index/22. Characteristics and mortality (median follow-up of 2.1 years) were compared between 2 groups: low GNRI (<92) with moderate or severe nutritional risk; and high GNRI (≥92) with no or low nutritional risk. Patients in the low-GNRI group were more often female, and had lower serum hemoglobin and sodium, but higher serum blood urea nitrogen (BUN), C-reactive protein, and B-type natriuretic peptide (BNP) compared to those in the high-GNRI group (P<0.05, respectively). Physical activity at discharge measured by Barthel index was significantly lower in the low-GNRI group than the high-GNRI group (P<0.05). On Cox hazard analysis, lower GNRI predicted increased mortality independent of age, gender, prior HF hospitalization, and higher BUN and BNP (P<0.01). Conclusions: GNRI may be useful for predicting functional dependency and mortality in patients with HFpEF.  (Circ J 2013; 77: 705–711)