Department of Cardiovascular Medicine, Ina Central Hospital, Ina, Japan.
Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
Sci Rep. 2021 Jul 22;11(1):14989. doi: 10.1038/s41598-021-94525-6.
The Glasgow Prognostic Score (GPS) has been established as a useful resource to evaluate inflammation and malnutrition and predict prognosis in several cancers. However, its prognostic significance in patients with heart failure (HF) is not well established. To investigate the association between the GPS and mortality in patients with HF, we assessed 870 patients who were 20 years old and more and had been admitted for acute decompensated HF. The GPS ranged from 0 to 2 points as previously reported. Over the 18-month follow-up (follow-up rate, 83.9%), 143 patients died. Increasing GPS was associated with higher HF severity assessed by New York Heart Association functional class and B-type natriuretic peptide (BNP) levels. Kaplan-Meier analysis showed significant associations for mortality and increased GPS. In multivariate analysis, compared to the GPS 0 group, the GPS 2 group was associated with high mortality (hazard ratio 2.92, 95% confidence interval 1.77-4.81, p < 0.001) after adjustment for age, sex, blood pressure, HF history, HF severity, hemoglobin, renal function, sodium, BNP, left ventricular ejection fraction, and anti-HF medications. In conclusion, high GPS was significantly associated with worse prognosis in patients with HF. Inflammation-based assessment by the GPS may enable simple evaluation of HF severity and prognosis.
格拉斯哥预后评分（GPS）已被确立为评估炎症和营养不良并预测多种癌症预后的有用资源。然而，其在心力衰竭（HF）患者中的预后意义尚未得到充分证实。为了研究 GPS 与 HF 患者死亡率之间的关系，我们评估了 870 名年龄在 20 岁及以上并因急性失代偿性 HF 入院的患者。GPS 范围如前所述为 0 至 2 分。在 18 个月的随访期间（随访率为 83.9%），有 143 名患者死亡。GPS 升高与纽约心脏协会功能分级和 B 型利钠肽（BNP）水平评估的 HF 严重程度更高相关。Kaplan-Meier 分析显示死亡率和 GPS 升高之间存在显著相关性。多变量分析显示，与 GPS 0 组相比，GPS 2 组与高死亡率相关（风险比 2.92，95%置信区间 1.77-4.81，p<0.001），校正年龄、性别、血压、HF 病史、HF 严重程度、血红蛋白、肾功能、钠、BNP、左心室射血分数和抗 HF 药物后。总之，高 GPS 与 HF 患者的预后较差显著相关。GPS 基于炎症的评估可能能够简单评估 HF 的严重程度和预后。
