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那不勒斯预后评分在预测心力衰竭患者长期死亡率中的重要性。

The importance of Naples prognostic score in predicting long-term mortality in heart failure patients.

作者信息

Aydın Sidar Şiyar, Aydemir Selim, Özmen Murat, Aksakal Emrah, Saraç İbrahim, Aydınyılmaz Faruk, Altınkaya Onur, Birdal Oğuzhan, Tanboğa İbrahim Halil

机构信息

Department of Cardiology, Faculty of Medicine, Atatürk University, Erzurum, Turkey.

Department of Cardiology, University of Health Sciences, Erzurum City Hospital, Erzurum, Turkey.

出版信息

Ann Med. 2025 Dec;57(1):2442536. doi: 10.1080/07853890.2024.2442536. Epub 2024 Dec 14.

Abstract

BACKGROUND

Heart failure (HF) remains a significant health problem despite advances in diagnosis and treatment options. Malnutrition and increased inflammation predict poor disease prognosis. The parameters of the Naples prognostic score (NPS) include albumin, total cholesterol, neutrophil-lymphocyte ratio (NLR), and lymphocyte-monocyte ratio (LMR). We aimed to assess the potential of NPS as a predictor of long-term mortality in patients with HF.

METHODS

A total of 1728 patients with HF who applied to our center between 2018 and 2022 were included in this study. The NPS was computed and the patients were divided into three groups according to their NPS values as follows: NPS = 0 (Group 1), NPS = 1-2 (Group 2), and NPS = 3-4 (Group 3). We also evaluated the association between NPS value and HF mortality.

RESULTS

The patients were followed for a mean follow-up duration of 30 months. The mortality rate was 8.3% (145 patients). We carried out Model-1 and -2 Cox regression analyses to identify long-term mortality determinants. Model-2 was constructed by adding NPS to Model-1. NPS was significantly associated with HF mortality (Hazard Ratio: 2.194, 95% Confidence Interval: 1.176-4.091,  = 0.014). According to the Kaplan-Meier plot and log-rank analyses, there was a statistically significant difference in the long-term mortality of patients with HF and their NPS values for the entire cohort.

CONCLUSION

Based on our findings, NPS showed promise as an independent predictor of long-term mortality in individuals with HF.

摘要

背景

尽管在诊断和治疗方法上取得了进展,但心力衰竭(HF)仍然是一个重大的健康问题。营养不良和炎症增加预示着疾病预后不良。那不勒斯预后评分(NPS)的参数包括白蛋白、总胆固醇、中性粒细胞与淋巴细胞比率(NLR)和淋巴细胞与单核细胞比率(LMR)。我们旨在评估NPS作为HF患者长期死亡率预测指标的潜力。

方法

本研究纳入了2018年至2022年间到我们中心就诊的1728例HF患者。计算NPS,并根据NPS值将患者分为三组:NPS = 0(第1组),NPS = 1 - 2(第2组),NPS = 3 - 4(第3组)。我们还评估了NPS值与HF死亡率之间的关联。

结果

患者的平均随访时间为30个月。死亡率为8.3%(145例患者)。我们进行了模型1和模型2的Cox回归分析以确定长期死亡率的决定因素。模型2是通过在模型1中加入NPS构建的。NPS与HF死亡率显著相关(风险比:2.194,95%置信区间:1.176 - 4.091,P = 0.014)。根据Kaplan - Meier曲线和对数秩分析,整个队列中HF患者的长期死亡率与其NPS值存在统计学显著差异。

结论

基于我们的研究结果,NPS有望作为HF患者长期死亡率的独立预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5017/11648133/1d9fb3cb58b5/IANN_A_2442536_F0001_B.jpg

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