Does the Naples Prognostic Score Predict Long-Term Mortality in Patients with Advanced-Stage Heart Failure?

BACKGROUND

Inflammation and malnutrition have negative effects on heart failure. The Naples Prognostic Score (NPS) is a new scoring system that incorporates these two parameters.

OBJECTIVES

Our aim was to investigate the relationship between the NPS and long-term mortality in patients with advanced-stage heart failure.

METHODS

The study included 148 patients with advanced-stage heart failure. The patients were divided into two groups: those who died, and those who survived. Demographic, clinical, and laboratory characteristics of the groups were compared. The impact of NPS on mortality was examined.

RESULTS

The patients were further classified into three groups according to NPS. The patients with NPS 3 had a higher mortality rate compared to those with NPS 1 and NPS 2 (died vs. survived respectively, NPS 3: 75% vs. 25%, NPS 1: 31.1% vs. 68.9%, NPS 2: 48.9% vs. 51.1%, p < 0.001). In multivariate regression analysis, NPS 3 was found to be an independent predictor [odds ratio: 0.13, 95% confidence interval (CI): 0.051-0.333; p = 0.0001]. Receiver operating characteristic analysis revealed that NPS had a sensitivity of 82% and specificity of 53% for mortality, with an area under curve of 0.699 (95% CI: 0.614-0.784, p = 0.0001). Kaplan-Meier survival analysis demonstrated a higher mortality rate in those with a high NPS (long-rank: 5.29, p = 0.021). In patients with advanced-stage heart failure, NPS may be considered a determinant of long-term mortality.

CONCLUSIONS

This study demonstrated an association between NPS and long-term mortality in patients with advanced-stage heart failure. NPS, indicating inflammation and nutritional status, can be utilized as a long-term prognostic indicator in patients with advanced-stage heart failure.