Prognostic Value of Four Objective Nutritional Indices in Predicting Long-Term Prognosis in Elderly Patients with Atrial Fibrillation: A Retrospective Cohort Study.

IF 3.5 3区 医学 Q2 GERIATRICS & GERONTOLOGY
Clinical Interventions in Aging Pub Date : 2024-12-04 eCollection Date: 2024-01-01 DOI:10.2147/CIA.S493726
Qingwei He, Xingman Fan, Bowen Li, Qiongyi He, Yukun Cao, Haitao Zhang
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引用次数: 0

Abstract

Background: Several objective and comprehensive nutritional assessment methods have been used for predicting adverse outcomes in elderly patients with various diseases. However, their predictive value for long-term adverse outcomes in elderly patients with atrial fibrillation (AF) is unclear. This study aimed to explore the prognostic significance of the four nutritional indices, namely Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI), Controlling Nutritional Status (CONUT), and High-Sensitivity Modified Glasgow Prognostic Score (HS-mGPS), in evaluating the long-term prognosis in elderly patients with AF.

Methods: This retrospective study was conducted at a single center and included a total of 261 elderly patients with AF from December 2015 to December 2021. Patients were divided into all-cause death and survival groups based on the follow-up results. Kaplan-Meier analysis and COX regression were conducted to explore the relationship between all-cause mortality and nutritional scores. In addition, Receiver Operating Characteristic (ROC) curves were used to compare the predictive value of the four nutritional screening tools for the endpoint event.

Results: During the follow-up period, 119 cases (45.59%) of all-cause mortality were recorded. The cumulative incidence of all-cause death was significantly higher in participants with a lower PNI, lower GNRI, higher CONUT, and higher HS-mGPS levels. And the low PNI (HR 1.325, 95% CI 1.032-2.857, P=0.025) and the high HS-mGPS (HR 2.166, 95% CI 1.281-4.326, P=0.023) groups were independently and significantly associated with increased risk of all-cause death analyzed by multivariate COX regression. Additionally, PNI showed the best area under the curve value (AUC: 0.696, 95% CI 0.632-0.760 P < 0.001) for the prediction of all-cause mortality compared with the other nutritional indices.

Conclusion: Among the four nutritional risk screening tools, PNI might be a simple and useful indicator in predicting the long-term prognosis of elderly patients with AF.

四项客观营养指标在预测老年房颤患者长期预后中的预后价值:一项回顾性队列研究。
背景:几种客观、全面的营养评估方法已被用于预测老年各种疾病患者的不良结局。然而,它们对老年心房颤动(AF)患者长期不良结局的预测价值尚不清楚。本研究旨在探讨预后营养指数(PNI)、老年营养风险指数(GNRI)、控制营养状况(CONUT)和高灵敏度修正格拉斯哥预后评分(HS-mGPS)四项营养指标在评价老年af患者长期预后中的预后意义。本回顾性研究在单中心进行,共纳入2015年12月至2021年12月261例老年房颤患者。根据随访结果将患者分为全因死亡组和生存组。采用Kaplan-Meier分析和COX回归探讨全因死亡率与营养评分之间的关系。此外,采用受试者工作特征(ROC)曲线比较四种营养筛查工具对终点事件的预测价值。结果:随访期间共记录全因死亡率119例,占45.59%。低PNI、低GNRI、高CONUT和高HS-mGPS水平的参与者,全因死亡的累积发生率明显更高。多因素COX回归分析,低PNI组(HR 1.325, 95% CI 1.032 ~ 2.857, P=0.025)和高HS-mGPS组(HR 2.166, 95% CI 1.281 ~ 4.326, P=0.023)与全因死亡风险增加独立且显著相关。与其他营养指标相比,PNI曲线下面积(AUC: 0.696, 95% CI 0.632 ~ 0.760 P < 0.001)预测全因死亡率最佳。结论:在4种营养风险筛查工具中,PNI可能是预测老年房颤患者长期预后的一种简单有效的指标。
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来源期刊
Clinical Interventions in Aging
Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-
CiteScore
6.80
自引率
2.80%
发文量
193
审稿时长
6-12 weeks
期刊介绍: Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.
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