Kubota Kayoko, Miyanaga Sunao, Iwatani Noriko, Higo Kenjuro, Tokushige Akihiro, Ikeda Yoshiyuki, Ohishi Mitsuru
Departments of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University Kagoshima Japan.
Circ Rep. 2020 Jun 12;2(7):372-377. doi: 10.1253/circrep.CR-20-0046.
The Geriatric Nutritional Risk Index (GNRI) is a simple tool for assessing nutritional risk that predicts prognosis in patients with heart failure. This study evaluated associations between the GNRI at first hospitalization and prognosis in patients with pulmonary artery hypertension (PAH) and those with chronic thromboembolic pulmonary hypertension (CTEPH). This retrospective investigation included 104 patients with either PAH or CTEPH who were treated at Kagoshima University Hospital in Japan. Patients were divided into a high (≥92) and low (<92) GNRI groups. Body mass index and serum albumin levels were significantly lower in the low GNRI group (P<0.001). Over a median follow-up period of 24 months, the incidence of pulmonary hypertension rehospitalization was higher in the low GNRI group (P=0.04). Kaplan-Meier analysis revealed that the cumulative event-free rate was significantly lower in the low GNRI group (P=0.002). Low GNRI was significantly associated with a poorer outcome after adjusting for different sets of confounding factors, including: age and sex (P=0.004); age, sex, and PAH (P=0.043); and age, sex, and mean pulmonary artery pressure (P=0.003). The GNRI at first hospitalization is useful for predicting prognosis in PAH and CTEPH patients.
老年营养风险指数（GNRI）是一种用于评估营养风险的简单工具，可预测心力衰竭患者的预后。本研究评估了首次住院时的GNRI与肺动脉高压（PAH）患者和慢性血栓栓塞性肺动脉高压（CTEPH）患者预后之间的关联。这项回顾性研究纳入了104例在日本鹿儿岛大学医院接受治疗的PAH或CTEPH患者。患者被分为高GNRI组（≥92）和低GNRI组（<92）。低GNRI组的体重指数和血清白蛋白水平显著较低（P<0.001）。在中位随访期24个月内，低GNRI组肺动脉高压再住院发生率较高（P=0.04）。Kaplan-Meier分析显示，低GNRI组的累积无事件发生率显著较低（P=0.002）。在调整了包括年龄和性别（P=0.004）、年龄、性别和PAH（P=0.043）以及年龄、性别和平均肺动脉压（P=0.003）等不同组别的混杂因素后，低GNRI与较差的预后显著相关。首次住院时的GNRI有助于预测PAH和CTEPH患者的预后。
