Jia Yu, Gao Yongli, Li Dongze, Cao Yu, Cheng Yisong, Li Fanghui, Xiao Lei, Jiang Ying, Wan Zhi, Zeng Zhi, Zeng Rui
Yu Jia, MBBS Doctor, Department of Emergency Medicine and Researcher, Laboratory of Emergency Medicine, Staff, West China School of Nursing, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, China. Yongli Gao, BSc Nurse, Department of Emergency Medicine and Researcher, Laboratory of Emergency Medicine, Teacher, West China School of Nursing, West China Hospital, and Committee Member, Disaster Medical Center, Sichuan University, Chengdu, China. Dongze Li, MBBS Doctor, Department of Emergency Medicine and Researcher, Laboratory of Emergency Medicine, Staff, West China School of Nursing, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, China. Yu Cao, MD Doctor, Department of Emergency Medicine and Researcher, Laboratory of Emergency Medicine, West China Hospital, and Committee Member Disaster Medical Center, Sichuan University, Chengdu, China. Yisong Cheng, MBBS Doctor, Department of Cardiology and Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China. Fanghui Li, MBBS Doctor, Department of Cardiology, and Staff at West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China. Lei Xiao, MBBS Doctor, Department of Cardiology, West China Hospital, Sichuan University; and Department of Cardiology, Chengdu BOE Hospital, Chengdu, China. Ying Jiang, MBBS Doctor, Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China. Zhi Wan, MD Doctor, Department of Emergency Medicine and Researcher, Laboratory of Emergency Medicine, West China Hospital, and Committee Member Disaster Medical Center, Sichuan University, Chengdu, China. Zhi Zeng, MD Doctor, Department of Emergency Medicine and Researcher, Laboratory of Emergency Medicine, West China Hospital, and Committee Member, Disaster Medical Center, Sichuan University, Chengdu, China. Rui Zeng, MD Doctor, Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
J Cardiovasc Nurs. 2020 Nov/Dec;35(6):E44-E52. doi: 10.1097/JCN.0000000000000674.
The Geriatric Nutritional Risk Index (GNRI), based on serum albumin levels and body index, is a simple nutrition-related risk assessment instrument.
We aimed to evaluate the prognostic value of GNRI in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention.
We retrospectively analyzed in-hospital and long-term adverse outcomes of 786 patients with STEMI. Patients were divided into 2 groups based on their GNRI score (≤98 vs >98). Kaplan-Meier curves and Cox regression models were used to evaluate the prognostic value of the GNRI score in patients with STEMI.
Of the patients enrolled, 78 (9.9%) died of cardiovascular disease during the median follow-up period of 12.4 (8.3-15.5) months. Patients with a GNRI score of 98 or lower had a higher incidence of bleeding, cardiogenic shock, infection, acute respiratory failure, malignant dysrhythmia, atrial fibrillation, and in-hospital mortality as well as a longer length of hospital stay (P < .05). Kaplan-Meier survival analysis showed that patients with a lower GNRI score had lower cumulative survival (P < .001), regardless of age group (elderly vs middle-aged) or sex. Multivariable Cox regression analysis showed that the adjusted hazard ratio of the GNRI score for cardiovascular death was 0.934 (95% confidence interval, 0.896-0.974; P = .001).
The GNRI can be used to assess prognosis of patients with STEMI and to identify those who may benefit from further nutritional assessment and intervention.
基于血清白蛋白水平和身体指数的老年营养风险指数（GNRI）是一种简单的营养相关风险评估工具。
我们旨在评估GNRI对接受直接经皮冠状动脉介入治疗的ST段抬高型心肌梗死（STEMI）患者的预后价值。
我们回顾性分析了786例STEMI患者的住院期间及长期不良结局。根据GNRI评分将患者分为两组（≤98 vs >98）。采用Kaplan-Meier曲线和Cox回归模型评估GNRI评分对STEMI患者的预后价值。
在纳入的患者中，在12.4（8.3 - 15.5）个月的中位随访期内，78例（9.9%）死于心血管疾病。GNRI评分为98或更低的患者出血、心源性休克、感染、急性呼吸衰竭、恶性心律失常、心房颤动及住院死亡率的发生率更高，且住院时间更长（P <.05）。Kaplan-Meier生存分析显示，无论年龄组（老年与中年）或性别如何，GNRI评分较低的患者累积生存率较低（P <.001）。多变量Cox回归分析显示，GNRI评分对心血管死亡的调整后风险比为0.934（95%置信区间，0.896 - 0.974；P =.001）。
GNRI可用于评估STEMI患者的预后，并识别那些可能从进一步营养评估和干预中获益的患者。
