老年心力衰竭患者营养风险指数的预后价值：一项荟萃分析。
Prognostic value of geriatric nutritional risk index in elderly patients with heart failure: a meta-analysis.
机构信息
Department of Cardiology, Hwa Mei Hospital, University of Chinese Academy of Sciences, No. 41 Northwest Street, Haishu District, Ningbo, 315000, Zhejiang, China.
Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, 315000, Zhejiang, China.
出版信息
Aging Clin Exp Res. 2021 Jun;33(6):1477-1486. doi: 10.1007/s40520-020-01656-3. Epub 2020 Aug 6.
BACKGROUND
Geriatric Nutritional Risk Index (GNRI) is a promising tool for predicting nutrition-related complications. This meta-analysis sought to determine the prognostic utility of GNRI in elderly patients with heart failure.
METHODS
We comprehensively searched the PubMed and Embase databases from their inception to July 2019. Original studies investigating the prognostic value of GNRI in patients with heart failure were included. Outcome of interests were all-cause mortality and major cardiovascular events. The prognostic value of GNRI was expressed as risk ratios (RR) with 95% confidence intervals (CI) for the lowest versus the highest GNRI category or continuous GNRI analysis.
RESULTS
Eleven articles (10 studies) involving 10,589 elderly heart failure patients were included. Meta-analysis indicated that heart failure patients with the lowest GNRI had an increased risk of all-cause mortality (RR 2.11; 95% CI 1.72-2.58) and major cardiovascular events (RR 2.00; 95% CI 1.24-3.22) after adjustment for confounding. In addition, each unit reduction in GNRI significantly increased 6% risk of all-cause mortality.
CONCLUSION
Lower GNRI independently predicts all-cause mortality and major cardiovascular events in elderly patients with heart failure. Determination of nutritional status using GNRI may improve risk stratification in elderly patients with heart failure.
背景
老年营养风险指数（GNRI）是预测与营养相关并发症的有前途的工具。本荟萃分析旨在确定 GNRI 在老年心力衰竭患者中的预后价值。
方法
我们全面检索了 PubMed 和 Embase 数据库，检索时间从建库至 2019 年 7 月。纳入研究 GNRI 对心力衰竭患者预后价值的原始研究。主要研究终点为全因死亡率和主要心血管事件。GNRI 的预后价值用最低 GNRI 类别与最高 GNRI 类别或连续 GNRI 分析的风险比（RR）及其 95%置信区间（CI）表示。
结果
纳入了 11 篇文章（10 项研究），共纳入 10589 例老年心力衰竭患者。荟萃分析表明，校正混杂因素后，GNRI 最低的心力衰竭患者全因死亡率（RR 2.11；95%CI 1.72-2.58）和主要心血管事件（RR 2.00；95%CI 1.24-3.22）的风险增加。此外，GNRI 每降低一个单位，全因死亡率的风险增加 6%。
结论
较低的 GNRI 独立预测老年心力衰竭患者的全因死亡率和主要心血管事件。使用 GNRI 确定营养状况可能会改善老年心力衰竭患者的风险分层。
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