Impact of objective nutritional indexes on 1-year mortality after transcatheter aortic valve implantation: a prospective observational cohort study

Küçükosmanoğlu, Mehmet; Kılıç, Salih; Urgun, Örsan Deniz; Şahin, Şeyda; Yıldırım, Arafat; Şen, Ömer; Kurt, Ibrahim Halil

doi:10.1080/00015385.2020.1747177

Cited by 7 publications

(9 citation statements)

References 35 publications

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“…Our results are consistent with other studies evaluating the GNRI in TAVR patients, which found a significantly higher mortality rate at 3 months 20 or 1 year 15,21,22 among patients with a low baseline GNRI compared to those with a high GNRI. These studies also confirmed a low GNRI to be an independent risk factor for all‐cause mortality in multivariable analyses 15,21,22 . In a study involving 412 patients that used the same GNRI cut‐off as our study, GNRI ≤ 98 was associated with an adjusted HR of 3.77 (1.54–9.20) for all‐cause mortality at 1 year 21 .…”

Section: Discussionsupporting

confidence: 92%

“…Two small studies have compared the value of the GNRI, PNI and CONUT for predicting 1‐year mortality in TAVR patients, with conflicting results. One found that the CONUT and PNI were superior to the GNRI, 33 whereas the other found that the GNRI had better predictive value than the CONUT or PNI 22 . Additional studies are needed to clarify whether any of these indices is better than the others for predicting outcomes in TAVR patients.…”

Section: Discussionmentioning

confidence: 98%

“…Whereas some nutritional assessment strategies can be time consuming and cumbersome, 16 the Geriatric Nutritional Risk Index (GNRI) is a simple and well‐established nutritional screening tool that may help predict the risk of morbidity and mortality in elderly patients 17–19 . However, the prognostic value of the GNRI in patients undergoing TAVR has only been assessed in a few studies, 15,20–22 and additional data are needed to clarify its role in this context.…”

Section: Introductionmentioning

confidence: 99%

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Frailty in patients undergoing transcatheter aortic valve replacement: prognostic value of the Geriatric Nutritional Risk Index

Seoudy

Al‐Kassou

Shamekhi

et al. 2021

J cachexia sarcopenia muscle

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Background Malnutrition is a hallmark of frailty, is common among elderly patients, and is a predictor of poor outcomes in patients with severe symptomatic aortic stenosis (AS). The Geriatric Nutritional Risk Index (GNRI) is a simple and well‐established screening tool to predict the risk of morbidity and mortality in elderly patients. In this study, we evaluated whether GNRI may be used in the risk stratification and management of patients undergoing transcatheter aortic valve replacement (TAVR). Methods Patients with symptomatic severe AS (n = 953) who underwent transfemoral TAVR at the University Hospital Schleswig‐Holstein Kiel, Germany, between 2010 and 2019 (development cohort) were divided into two groups: normal GNRI ≥ 98 (no nutrition‐related risk; n = 618) versus low GNRI < 98 (at nutrition‐related risk; n = 335). The results were validated in an independent (validation) cohort from another high‐volume TAVR centre (n = 977). Results The low‐GNRI group had a higher proportion of female patients (59.1% vs. 52.1%), higher median age (82.9 vs. 81.8 years), prevalence of atrial fibrillation (50.4% vs. 40.0%), median logistic EuroSCORE (17.5% vs. 15.0%) and impaired left ventricular function (<35%: 10.7% vs. 6.8%), lower median estimated glomerular filtration rate (50 vs. 57 mL/min/1.73 m2) and median albumin level (3.5 vs. 4.0 g/dL) compared with the normal‐GNRI group. Among peri‐procedural complications, Acute Kidney Injury Network (AKIN) Stage 3 was more common in the low‐GNRI group (3.6% vs. 0.6%, p = 0.002). After a mean follow‐up of 21.1 months, all‐cause mortality was significantly increased in the low‐GNRI group compared with the normal‐GNRI group (p < 0.001). This was confirmed in the validation cohort (p < 0.001). Low GNRI < 98 was identified as an independent risk factor for all‐cause mortality (hazard ratio 1.44, 95% CI 1.01–2.04, p = 0.043). Other independent risk factors included albumin level < median of 4.0 g/dL, high‐sensitive troponin T in the highest quartile (> 45.0 pg/mL), N‐terminal pro‐B‐type natriuretic peptide in the highest quartile (> 3595 pg/mL), grade III–IV tricuspid regurgitation, pulmonary arterial hypertension, life‐threatening bleeding, AKIN Stage 3 and disabling stroke. Conclusions Low GNRI score was associated with an increased risk of all‐cause mortality in patients undergoing TAVR, implying that this vulnerable group may benefit from improved preventive measures.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Frailty in patients undergoing transcatheter aortic valve replacement: prognostic value of the Geriatric Nutritional Risk Index

Seoudy

Al‐Kassou

Shamekhi

et al. 2021

J cachexia sarcopenia muscle

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“…A busca na literatura identificou 426 registros no total, dos quais 22 foram avaliados com mais detalhes e 19 publicações, sendo 13 de estudos observacionais prospectivos (Bayram et al, 2022;Cai et al, 2022;Cho et al, 2021;Felpel et al, 2021;Gürbak et al, 2021;Kurumisawa & Kawahito, 2018;Lee et al, 2020;Lin et al, 2021;Öcal et al, 2020;Okuno et al, 2019;Tasbulak et al, 2021;Yost et al, 2018) e 6 estudos observacionais prospectivos (Açıkel & Korkut, 2019;Kucukosmanoglu et al, 2021;Mas-Peiro et al, 2021;Panç et al, 2020;Tóth et al, 2022), foram incluídos na revisão sistemática, podendo ser visualizados na Tabela 1, que traz as informações de autoria, tipo e período do estudo, além do número de participantes e de casos, e objetivo e resultados encontrados nos artigos inclusos na presente revisão. Quanto ao local de realização das pesquisas, 9 dos estudos foram da Europa, dois dos EUA e 5 da Ásia e a duração do seguimento variou de 1 a 10 anos.…”

Section: Resultsunclassified

“…Quanto ao local de realização das pesquisas, 9 dos estudos foram da Europa, dois dos EUA e 5 da Ásia e a duração do seguimento variou de 1 a 10 anos. 6 estudos faziam comparação com outros índices (Açıkel & Korkut, 2019;Cho et al, 2021;Felpel et al, 2021;Gürbak et al, 2021;Kucukosmanoglu et al, 2021;Tasbulak et al, 2021) Lee et al, 2020;Öcal et al, 2020;Yost et al, 2018), e 6 avaliaram a influência do IPN na mortalidade pós-cirúrgica (Cai et al, 2022;Kurumisawa & Kawahito, 2018;Lin et al, 2021;Mas-Peiro et al, 2021;Panç et al, 2020) (Figura 2).…”

Section: Resultsunclassified

Índice prognóstico nutricional como marcador em pacientes cirúrgicos cardíacos: uma revisão sistemática

Queiroz

Santos²,

Silva³

et al. 2022

RSD

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Introdução: Os avanços tecnológicos e os novos métodos cirúrgicos têm sido insuficientes para diminuir o alto risco de mortalidade e morbidade em pacientes submetidos à cirurgia cardíaca. Sabe-se que a desnutrição pré-operatória está correlacionada com morbidade, mortalidade, internação hospitalar e qualidade de vida após a cirurgia. O índice prognóstico nutricional (IPN) é calculado a partir dos níveis séricos de albumina e contagem de linfócitos periféricos. Estudos demonstraram que um IPN baixo é um fator prognóstico adverso independente de curto e longo prazo. Objetivo: Avaliar se o índice prognóstico nutricional é um bom marcador prognóstico para prever complicações e óbito em pacientes cirúrgicos cardíacos. Metodologia: Foi feito uma revisão sistemática nas bases de dado PubMed, Lilacs e SciELO, com os seguintes descritores: prognostic nutritional index and cardiac and surgery. Foram escolhido os artigos que avaliassem o IPN e complicações, incluindo óbito, em pacientes cirúrgicos cardíacos. Resultado: Foram analisadas e incluídos na revisão sistemática 19 publicações, destes 13 estudos observacionais prospectivos e 6 estudos observacionais retrospectivas. Deste estudos 9 foram comparações com outros índices, 4 sobre IPN e complicações pós-operatórias e 6 sobre IPN e mortalidade, em grande parte os estudos demonstram que o IPN é uma boa ferramenta para apontar mortalidade e complicações pós-operatórias. Conclusão: Os resultados sugerem que é possível o IPN é uma boa ferramenta para apontar risco de morte e complicações no pós-operatório de cirurgias cardíacas, porém um ponto de corte comum para cirurgia ainda não foi estabelecido.

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Meta-Analysis on the Association Between Nutritional Status and Outcomes After Transcatheter Aortic Valve Implantation

Kazemian¹,

Tavolinejad²,

Rashedi³

et al. 2023

The American Journal of Cardiology

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Impact of objective nutritional indexes on 1-year mortality after transcatheter aortic valve implantation: a prospective observational cohort study

Cited by 7 publications

References 35 publications

Frailty in patients undergoing transcatheter aortic valve replacement: prognostic value of the Geriatric Nutritional Risk Index

Frailty in patients undergoing transcatheter aortic valve replacement: prognostic value of the Geriatric Nutritional Risk Index

Índice prognóstico nutricional como marcador em pacientes cirúrgicos cardíacos: uma revisão sistemática

Meta-Analysis on the Association Between Nutritional Status and Outcomes After Transcatheter Aortic Valve Implantation

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