Nutritional risk index as a predictor of mortality in acutely decompensated heart failure

Jae Yeong Cho, Kye Hun Kim, Hyun Jai Cho, Hae Young Lee, Jin Oh Choi, Eun Seok Jeon, Sang Eun Lee, Min Seok Kim, Jae Joong Kim, Kyung Kuk Hwang, Shung Chull Chae, Sang Hong Baek, Seok Min Kang, Dong Ju Choi, Byung Su Yoo, Youngkeun Ahn, Hyun Young Park, Myeong Chan Cho, Byung Hee Oh

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Abstract

Background We investigated the role of nutritional risk index (NRI) in predicting 1-year mortality in patients with acute decompensated heart failure (ADHF). Methods Among 5,625 cohort patients enrolled in Korean Acute Heart Failure (KorAHF) Registry, a total of 5,265 patients who were possible to calculate NRI [NRI = (1.519 x serum albumin [g/dl]) + (41.7 x weight [kg]/ideal body weight [kg])] were enrolled. The patients were divided into 4 groups according to the NRI quartile; Q1 <89 (n = 1121, 69.9 ± 14.5 years, 632 males), Q2 89–95 (n = 1234, 69.7 ± 14.4 years, 677 males), Q3 95–100 (n = 1199, 68.8 ± 14.0 years, 849 males), Q4 >100 (n = 1711, 65.6 ± 14.5 years, 779 males). Primary end-point was all-cause mortality at 1-year clinical follow-up. Results The 1-year mortality was significantly increased as the NRI quartile decreased, and the lowest NRI quartile was associated with the highest 1-year mortality (Q1: 27.5% vs. Q2: 20.9% vs. Q3: 12.9% vs. Q4: 8.7%, linear p <0.001). On Kaplan-Meier survival analysis, the significant inter-quartile difference was observed (p <0.001 for all). In multivariate analysis using Cox proportional hazard regression, the lowest NRI quartile was an independent predictor of 1-year mortality in patients with ADHF. Conclusions Poor nutritional status as assessed by NRI and quartile grading of NRI was associated with 1-year mortality in Korean patients with ADHF. The assessment of nutritional status by NRI may provide additional prognostic information and thus would be useful in the risk stratification of the patients with ADHF.

Original languageEnglish
Article numbere0209088
JournalPloS one
Volume13
Issue number12
DOIs
Publication statusPublished - 2018 Dec

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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    Cho, J. Y., Kim, K. H., Cho, H. J., Lee, H. Y., Choi, J. O., Jeon, E. S., Lee, S. E., Kim, M. S., Kim, J. J., Hwang, K. K., Chae, S. C., Baek, S. H., Kang, S. M., Choi, D. J., Yoo, B. S., Ahn, Y., Park, H. Y., Cho, M. C., & Oh, B. H. (2018). Nutritional risk index as a predictor of mortality in acutely decompensated heart failure. PloS one, 13(12), [e0209088]. https://doi.org/10.1371/journal.pone.0209088