Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia.
Health Sciences Department, Princess Nourah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia.
Nutrients. 2020 Dec 17;12(12):3868. doi: 10.3390/nu12123868.
Malnutrition among heart-transplant patients may affect survival. The aim was to investigate the survival and nutrition status among male and female heart transplant patients who underwent transplantation, before and 1 year after surgery based on the nutritional risk index (NRI). The medical records of ninety heart-transplant patients (2009-2014) from the King Faisal Specialist Hospital, Riyadh, were reviewed. The assessment included demographic data, anthropometric measurements, and NRI calculation. Moreover, postoperative data included the length of stay and survival. Paired -test and survival analysis by Kaplan-Meier (KM) curves were used. A total of 90 patients (males 77.78%) were included. The prevalence of malnutrition in the preoperative phase by NRI was 60% (7.78% as severe; 40% as moderate, and 12.22% mild NRI scores). After 1 year, body mass index (BMI) and NRI increased significantly ( < 0.001). Furthermore, NRI was significantly different between men and women ( < 0.01), while KM survival curves were insignificantly different ( = 0.67). Recipients with postoperative moderate or severe nutritional risk (NRI < 97.5) had significantly shorter survival in the first-year post-transplantation (HR = 0.82; 95% CI, 0.75-0.89; < 0.001). Our findings indicate that the NRI after 1 year of transplant correlated significantly with mortality. Besides, there was no significant gender difference regarding survival; however, malnutrition and low survival were more prominent among women.
心脏移植患者的营养不良可能会影响存活率。本研究旨在通过营养风险指数（NRI），调查男性和女性心脏移植患者在手术前后的存活率和营养状况。我们回顾了利雅得法赫德国王专科医院 90 例心脏移植患者（2009-2014 年）的病历。评估内容包括人口统计学数据、人体测量学指标和 NRI 计算。此外，术后数据包括住院时间和存活率。采用配对 t 检验和 Kaplan-Meier（KM）曲线进行生存分析。共纳入 90 例患者（男性占 77.78%）。NRI 术前营养不良的发生率为 60%（严重程度为 7.78%，中度为 40%，轻度为 12.22%）。1 年后，体重指数（BMI）和 NRI 显著增加（<0.001）。此外，NRI 在男性和女性之间有显著差异（<0.01），而 KM 生存曲线无显著差异（=0.67）。术后中重度营养风险（NRI <97.5）的患者在移植后 1 年内的存活率明显较低（HR=0.82；95%CI，0.75-0.89；<0.001）。我们的研究结果表明，移植后 1 年的 NRI 与死亡率显著相关。此外，在存活率方面，性别无显著差异；然而，女性的营养不良和低存活率更为明显。
