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经导管主动脉瓣植入术后,简易营养评估简表对主动脉瓣狭窄的预后价值。

Prognostic value of Mini Nutritional Assessment-Short Form with aortic valve stenosis following transcatheter aortic valve implantation.

作者信息

Doi Shunichi, Ashikaga Kohei, Kida Keisuke, Watanabe Mika, Yoneyama Kihei, Suzuki Norio, Kuwata Shingo, Kaihara Toshiki, Koga Masashi, Okuyama Kazuaki, Kamijima Ryo, Tanabe Yasuhiro, Takeichi Naoya, Watanabe Satoshi, Izumo Masaki, Ishibashi Yuki, Akashi Yoshihiro J

机构信息

Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.

Department of Pharmacology, St. Marianna University School of Medicine, Kawasaki, Japan.

出版信息

ESC Heart Fail. 2020 Dec;7(6):4024-4031. doi: 10.1002/ehf2.13007. Epub 2020 Sep 10.

Abstract

AIMS

Older adults at risk for malnutrition are known to have a high mortality rate. This study aimed to investigate whether the Mini Nutritional Assessment-Short Form (MNA-SF) could predict midterm mortality in patients undergoing transcatheter aortic valve implantation (TAVI).

METHODS AND RESULTS

We applied the MNA-SF in 288 patients who had undergone TAVI from January 2016 to June 2019 at the St. Marianna University School of Medicine hospital. Using the MNA-SF cut-off value to indicate the risk of malnutrition, patients were divided into two groups, namely, those with an MNA-SF score ≤11 (impaired MNA-SF group) and those with an MNA-SF score ≥12 (maintained MNA-SF group). We used this value to investigate the association between the MNA-SF and all-cause mortality. Overall, 188 (65%) and 100 (35%) patients comprised the impaired MNA-SF and maintained MNA-SF groups, respectively, and 41 patients died after TAVI (mean follow-up duration, 458 ± 315 days). Kaplan-Meier analyses showed that patients in the impaired MNA-SF group had a significantly higher incidence of all-cause mortality (hazard ratio 2.67; 95% confidence interval 1.29-6.21; P = 0.01). Multivariate Cox regression analyses showed that the MNA-SF score was an independent predictor of all-cause mortality after adjusting for the Society of Thoracic Surgeons risk score, Katz Index, and brain natriuretic peptide test results (hazard ratio 1.14; 95% confidence interval 1.01-1.28; P = 0.04).

CONCLUSIONS

The MNA-SF was useful to screen for the risk of malnutrition in patients with TAVI and in predicting midterm prognoses in patients undergoing TAVI and could predict patient mortality after the procedure.

摘要

目的

已知有营养不良风险的老年人死亡率很高。本研究旨在调查微型营养评定简表(MNA-SF)能否预测经导管主动脉瓣植入术(TAVI)患者的中期死亡率。

方法与结果

我们对2016年1月至2019年6月在圣玛丽安娜大学医学院医院接受TAVI的288例患者应用了MNA-SF。使用MNA-SF临界值来表明营养不良风险,将患者分为两组,即MNA-SF评分≤11分的患者(MNA-SF受损组)和MNA-SF评分≥12分的患者(MNA-SF维持组)。我们用这个值来研究MNA-SF与全因死亡率之间的关联。总体而言,MNA-SF受损组和MNA-SF维持组分别有188例(65%)和100例(35%)患者,41例患者在TAVI术后死亡(平均随访时间,458±315天)。Kaplan-Meier分析显示,MNA-SF受损组患者的全因死亡率发生率显著更高(风险比2.67;95%置信区间1.29-6.21;P=0.01)。多变量Cox回归分析显示,在调整了胸外科医师协会风险评分、Katz指数和脑钠肽检测结果后,MNA-SF评分是全因死亡率的独立预测因素(风险比1.14;95%置信区间1.01-1.28;P=0.04)。

结论

MNA-SF有助于筛查TAVI患者的营养不良风险,并预测接受TAVI患者的中期预后,且能预测术后患者死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4272/7754760/6f2128934af8/EHF2-7-4024-g001.jpg

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