Dong Guoxia, Li Zhihua
Department of General Practice, Affiliated Hospital of Jining Medical University, Jining 272029, China.
Department of Cardiology, Affiliated Hospital of Jining Medical University, Jining 272029, China.
Cardiol Res Pract. 2024 Oct 24;2024:5692215. doi: 10.1155/2024/5692215. eCollection 2024.
The geriatric nutritional risk index (GNRI) is a valuable tool that may predict the prognosis of elderly patients with heart failure (HF). Malnutrition and low GNRI scores have been associated with a higher risk of hospitalization and mortality. This study aimed to investigate the association between GNRI and 6-month readmission for HF in elderly Chinese patients. The study utilized data from hospitalized HF patients by combining electronic medical records from the PhysioNet restricted health data database with external outcome data. In our study, we used the GNRI as the independent variable and assessed its association with the risk of readmission within 6 months. The main analytical methods were multivariable Cox regression, stratified analysis with interaction, threshold effect analysis, and Kaplan-Meier survival curves. This study involved 767 elderly HF patients, 61.3% of whom had malnutrition. In the threshold analysis, HF patients' 6-month readmission risk was significantly reduced with increasing GNRI, with a hazard ratio (HR) and 95% confidence interval (CI) of 0.99 (0.97.1). Malnutrition group was associated with a higher risk of readmission within 6 months for HF patients in analyses that were controlled for confounding factors, with HRs and their 95% CI of 1.17 (0.99, 1.38), 1.18 (1, 1.4), and 1.44 (1.08,1.93), respectively. Subgroup analysis showed that GNRI levels had a consistent impact on outcome events, unaffected by covariates. GNRI was negatively correlated with the outcome event of readmission within 6 months in elderly HF patients. Malnutrition group showed a higher risk of readmission within 6 months.
老年营养风险指数（GNRI）是一种有价值的工具，可用于预测老年心力衰竭（HF）患者的预后。营养不良和低GNRI评分与更高的住院和死亡风险相关。本研究旨在调查中国老年患者中GNRI与HF患者6个月再入院之间的关联。该研究通过将PhysioNet受限健康数据数据库中的电子病历与外部结局数据相结合，利用了住院HF患者的数据。在我们的研究中，我们将GNRI作为自变量，并评估其与6个月内再入院风险的关联。主要分析方法包括多变量Cox回归、交互作用分层分析、阈值效应分析和Kaplan-Meier生存曲线。本研究纳入了767例老年HF患者，其中61.3%存在营养不良。在阈值分析中，随着GNRI的增加，HF患者6个月再入院风险显著降低，风险比（HR）和95%置信区间（CI）为0.99（0.97，1.01）。在控制混杂因素的分析中，营养不良组与HF患者6个月内再入院风险较高相关，HR及其95%CI分别为1.17（0.99，1.38）、1.18（1.00，1.40）和1.44（1.08，1.93）。亚组分析表明，GNRI水平对结局事件有一致的影响，不受协变量影响。GNRI与老年HF患者6个月内再入院的结局事件呈负相关。营养不良组6个月内再入院风险较高。
