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Geriatric Nutritional Risk Index Score Predicts Clinical Outcome in Patients With Acute ST-Segment Elevation
Yu Jia1, Yongli Gao, Dongze Li
1Yu Jia, MBBS Doctor, Department of Emergency Medicine and Researcher, Laboratory of Emergency Medicine, Staff, West China School of Nursing, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, China. Yongli Gao, BSc Nurse, Department of Emergency Medicine and Researcher, Laboratory of Emergency Medicine, Teacher, West China School of Nursing, West China Hospital, and Committee Member, Disaster Medical Center, Sichuan University, Chengdu, China. Dongze Li, MBBS Doctor, Department of Emergency Medicine and Researcher, Laboratory of Emergency Medicine, Staff, West China School of Nursing, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, China. Yu Cao, MD Doctor, Department of Emergency Medicine and Researcher, Laboratory of Emergency Medicine, West China Hospital, and Committee Member Disaster Medical Center, Sichuan University, Chengdu, China. Yisong Cheng, MBBS Doctor, Department of Cardiology and Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China. Fanghui Li, MBBS Doctor, Department of Cardiology, and Staff at West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China. Lei Xiao, MBBS Doctor, Department of Cardiology, West China Hospital, Sichuan University; and Department of Cardiology, Chengdu BOE Hospital, Chengdu, China. Ying Jiang, MBBS Doctor, Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China. Zhi Wan, MD Doctor, Department of Emergency Medicine and Researcher, Laboratory of Emergency Medicine, West China Hospital, and Committee Member Disaster Medical Center, Sichuan University, Chengdu, China. Zhi Zeng, MD Doctor, Department of Emergency Medicine and Researcher, Laboratory of Emergency Medicine, West China Hospital, and Committee Member, Disaster Medical Center, Sichuan University, Chengdu, China. Rui Zeng, MD Doctor, Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
Background:
The Geriatric Nutritional Risk Index (GNRI), based on serum albumin levels and body index, is a simple nutrition-related risk assessment instrument.
Objective:
We aimed to evaluate the prognostic value of GNRI in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention.
Methods:
We retrospectively analyzed in-hospital and long-term adverse outcomes of 786 patients with STEMI. Patients were divided into 2 groups based on their GNRI score (≤98 vs >98). Kaplan-Meier curves and Cox regression models were used to evaluate the prognostic value of the GNRI score in patients with STEMI.
Results:
Of the patients enrolled, 78 (9.9%) died of cardiovascular disease during the median follow-up period of 12.4 (8.3-15.5) months. Patients with a GNRI score of 98 or lower had a higher incidence of bleeding, cardiogenic shock, infection, acute respiratory failure, malignant dysrhythmia, atrial fibrillation, and in-hospital mortality as well as a longer length of hospital stay (P < .05). Kaplan-Meier survival analysis showed that patients with a lower GNRI score had lower cumulative survival (P < .001), regardless of age group (elderly vs middle-aged) or sex. Multivariable Cox regression analysis showed that the adjusted hazard ratio of the GNRI score for cardiovascular death was 0.934 (95% confidence interval, 0.896-0.974; P = .001).
Conclusion:
The GNRI can be used to assess prognosis of patients with STEMI and to identify those who may benefit from further nutritional assessment and intervention.
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