Department of Medicine, Saitama Citizens Medical Center, Japan.
Department of Cardiology, Jichi Medical University Saitama Medical Center, Japan.
Eur J Cardiovasc Nurs. 2020 Feb;19(2):172-177. doi: 10.1177/1474515119864970. Epub 2019 Jul 21.
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.
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.
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%, < 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; = 0.02).
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.
老年患者营养不良是老龄化社会的重要问题之一。本研究旨在探讨老年营养风险指数（GNRI）评估的营养不良在因心力衰竭住院的非常高龄患者中的患病率和预后影响。
我们纳入了 213 例年龄 ⩾80 岁因心力衰竭住院的连续患者。患者的平均年龄为 87.2 ± 4.9 岁，其中 43.7%为男性。入院时的营养状况使用 GNRI 进行评估，计算公式为：14.89×血清白蛋白（g/dL）+41.7×体重指数/22。患者被分为低 GNRI 组（<92，有营养不良风险）和高 GNRI 组（⩾92，无营养不良风险）。
所有患者的平均 GNRI 为 90.7 ± 10.6，108 例（50.7%）患者存在低 GNRI。在 540 天的随访期间，低 GNRI 组的全因死亡率明显高于高 GNRI 组（35.7%比 12.9%，<0.001）。Cox 比例风险回归分析显示，低 GNRI 是死亡的独立预测因素（风险比，2.28；95%置信区间，1.15-4.49；P=0.02）。
入院时低 GNRI 较为常见，与因心力衰竭住院的 ⩾80 岁患者预后不良相关。
