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营养状况对经导管主动脉瓣植入术结局的影响。

The Impact of Nutritional Status on the Outcome of Transcatheter Aortic Valve Implantation.

作者信息

Sihag Vivendar, Li Wenyu, Hagar Abdullah, Peng Yong, Feng Yuan, Bhushan Sandeep, Chen Mao

机构信息

Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

2Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.

出版信息

Heart Surg Forum. 2022 Apr 20;25(2):E267-E272. doi: 10.1532/hsf.4547.

Abstract

BACKGROUND

The present study aims to evaluate how nutritional status may affect transcatheter aortic valve implantation (TAVI) outcomes.

MATERIALS AND METHODS

This is a retrospective study of 383 TAVI patients. In-hospital, 1-month, and 12-month survival was evaluated. Since most patients undergoing TAVI are over 75 years old, the NRI definition for a geriatric population (GNRI) was used. Preoperative baseline clinical and laboratory data were collected and then the corresponding nutritional status was calculated, including Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNRI), and Controlling Nutritional Status Score (CONUT). Survival analysis and receiver operating characteristic curve (ROC) analysis were used to evaluate the correlation between these parameters and TAVI outcome.

RESULTS

By CONUT and GNRI scores, 168 (58.9%) and 40 (14.0%) patients were considered to have mild malnutrition, respectively. By using PNI, CONUT, and GNRI scores, 16 (5.7%), 29 (10.3%), and 39 (13.7%) patients were moderately or severely malnourished. Survival analysis showed that patients with worse nutritional status had a worse prognosis regardless of the nutritional score used. Subgroup analysis showed that these differences remained significant in subgroups of patients over age 75. COX multivariate analysis showed that GNRI, PNI, and CONUT were independently associated with all-cause mortality during the follow-up.

CONCLUSION

Patients with worse nutritional status had a worse prognosis regardless of the nutritional score used. Subgroup analysis showed that these differences remained significant in subgroups of patients over age 75. GNRI, PNI, and CONUT were independent predictors of all-cause mortality after TAVI.

摘要

背景

本研究旨在评估营养状况如何影响经导管主动脉瓣植入术(TAVI)的疗效。

材料与方法

这是一项对383例TAVI患者的回顾性研究。评估了患者的住院、1个月和12个月生存率。由于大多数接受TAVI的患者年龄超过75岁,因此采用了老年人群的营养风险指数(GNRI)定义。收集术前基线临床和实验室数据,然后计算相应的营养状况,包括老年营养风险指数(GNRI)、预后营养指数(PNRI)和控制营养状况评分(CONUT)。采用生存分析和受试者工作特征曲线(ROC)分析来评估这些参数与TAVI疗效之间的相关性。

结果

根据CONUT和GNRI评分,分别有168例(58.9%)和40例(14.0%)患者被认为存在轻度营养不良。根据PNI、CONUT和GNRI评分,分别有16例(5.�%)、29例(10.3%)和39例(13.7%)患者存在中度或重度营养不良。生存分析表明,无论采用何种营养评分,营养状况较差的患者预后更差。亚组分析表明,这些差异在75岁以上患者亚组中仍然显著。COX多因素分析表明,GNRI、PNI和CONUT与随访期间的全因死亡率独立相关。

结论

无论采用何种营养评分,营养状况较差的患者预后更差。亚组分析表明,这些差异在75岁以上患者亚组中仍然显著。GNRI、PNI和CONUT是TAVI术后全因死亡率的独立预测因素。

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