Low levels of ALB, Hb, and GNRI significantly increased poor prognosis incidence (83.33%, 85.42%, and 91.67% vs 16.67%, 14.58%, and 8.33%) with strong predictive value (AUC 0.845, 0.884, 0.896) for 1-year rehospitalization or death in elderly CHF patients.
Observational (n=190)
No
Do nutritional status indexes (albumin, hemoglobin, GNRI) predict rehospitalization or all-cause death in elderly patients with chronic heart failure?
Reduced levels of albumin, hemoglobin, and the Geriatric Nutritional Risk Index (GNRI) are strong independent predictors of 1-year rehospitalization or all-cause mortality in elderly patients with chronic heart failure.
Effect estimate: HRs for independent prognostic factors: LVEF HR 1.114 (95% CI 1.003–1.238), NT-proBNP HR 1.013 (95% CI 1.007–1.019), NYHA class HR 2.220 (95% CI 1.188–4.148), ALB HR 1.279 (95% CI 1.052–1.555), Hb HR 0.872 (95% CI 0.792–0.960), GNRI HR 0.853 (95% CI 0.756–0.962)
Absolute Event Rate: 83.33% vs 16.67%
p-value: p=<0.05 for all listed HRs
Objective This study evaluated the prognostic value of nutritional status indexes albumin (ALB), hemoglobin (Hb), Geriatric Nutritional Risk Index (GNRI) in elderly chronic heart failure (CHF) patients. Methods A total of 190 elderly CHF patients were categorized into good ( n = 142) and poor ( n = 48) prognosis groups based on 1-year outcomes (rehospitalization or all-cause death). Clinical data, including cardiac function New York Heart Association (NYHA) class, inflammatory markers, and nutritional indexes (ALB, Hb, GNRI), were analyzed. Spearman correlation was used to assess the relationship between nutritional markers and NYHA class. Patients were stratified by median ALB, Hb, and GNRI levels to compare poor prognosis incidence. Kaplan–Meier survival and Cox regression analyses identified prognostic factors, while Receiver Operating Characteristic (ROC) curves evaluated predictive performance. Results The poor prognosis group exhibited significantly lower ALB, Hb, and GNRI levels ( P 0.001). These markers declined with worsening NYHA class ( P 0.001) and correlated negatively with cardiac function. Low ALB, Hb, and GNRI groups had higher poor prognosis rates ( P 0.001), confirmed by Kaplan–Meier analysis. Cox regression identified left ventricular ejection fraction (LVEF), N-terminal pro-B-type natriuretic peptide (NT-proBNP), NYHA class, ALB, Hb, and GNRI as independent prognostic factors. ROC analysis showed ALB area under the curve (AUC) = 0.845, Hb (AUC = 0.884), and GNRI (AUC = 0.896) as strong predictors with high sensitivity/specificity. Conclusion Reduced ALB, Hb, and GNRI levels are associated with poor CHF prognosis in elderly patients. These nutritional indexes offer reliable predictive value for clinical prognosis assessment.
Meng et al. (Tue,) conducted a observational in elderly chronic heart failure (n=190). nutritional status indexes (ALB, Hb, GNRI) assessment vs. higher vs lower nutritional index levels (median split) was evaluated on Poor prognosis defined as rehospitalization for heart failure or all-cause mortality within 1 year (HRs for independent prognostic factors: LVEF HR 1.114 (95% CI 1.003–1.238), NT-proBNP HR 1.013 (95% CI 1.007–1.019), NYHA class HR 2.220 (95% CI 1.188–4.148), ALB HR 1.279 (95% CI 1.052–1.555), Hb HR 0.872 (95% CI 0.792–0.960), GNRI HR 0.853 (95% CI 0.756–0.962), p=<0.05 for all listed HRs). Low levels of ALB, Hb, and GNRI significantly increased poor prognosis incidence (83.33%, 85.42%, and 91.67% vs 16.67%, 14.58%, and 8.33%) with strong predictive value (AUC 0.845, 0.884, 0.896) for 1-year rehospitalization or death in elderly CHF patients.