老年人营养风险指数与急性心力衰竭预后之间的关系
Zhanyuan Chen1, Yaoyao Wang1, Rui Zhu1
1Department of Nephrology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037, Beijing, China.
Nutrition, metabolism, and cardiovascular diseases : NMCD
|October 10, 2025
概括
老年营养风险指数 (GNRI) 有效预测急性心力衰竭 (AHF) 患者的不良结果. 较低的GNRI得分表明死亡风险更高,并改善了与其他营养标志物相比的预后准确性.
科学领域:
- 心脏病学 心脏病学
- 营养科学 营养科学
- 老年病的医生 老年病的医生
背景情况:
- 营养不良在心力衰竭 (HF) 中很常见,并与更糟糕的预后有关.
- 老年营养风险指数 (GNRI) 是一种简单的营养评估工具.
- 在急性心力衰竭 (AHF) 中GNRI的预后效用尚未得到充分证实.
研究的目的:
- 评估GNRI在AHF患者的预后价值.
- 确定GNRI是否能改善AHF中不良结果的风险分层.
主要方法:
- 中国的一项全国性前性队列研究包括4314名AHF患者.
- 使用GNRI评估了基线营养状况.
- 考克斯回归模型和哈雷尔一致性指数 (C指数) 用于分析GNRI与死亡率的关联及其增量预后价值.
主要成果:
- 营养不良 (GNRI ≤98) 与所有原因死亡率 (HR1.48),心血管死亡率 (HR1.42),主要心血管不良事件 (HR1.25) 和高风险住院 (HR1.32) 的风险显著增加有关.
- 作为连续变量的GNRI显示了与死亡风险的反向线性关联.
- 将GNRI纳入多变量模型改善了对死亡率的预测准确性 (ACM C指数0.700与0.692;CVM C指数0.711与0.706),并提供了比单独的BMI或血清白蛋白更好的预后价值.
结论:
- 较低的GNRI得分与AHF患者的不良结果增加有关.
- GNRI为AHF的死亡率预测提供了显著的额外预后价值.
- GNRI是一个有价值的,可访问的工具,应该纳入AHF风险分层策略.
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