Importance of Geriatric Nutritional Risk Index assessment in patients undergoing transcatheter aortic valve replacement

Shibata, Kenichi; Yamamoto, Masanori; Kano, Seiji; Kōyama, Yutaka; Shimura, Tetsuro; Kagase, Ai; Yamada, Sumio; Kobayashi, Toshihiro; Tada, Norio; Naganuma, Toru; Araki, Motoharu; Yamanaka, Futoshi; Shirai, Shinichi; Mizutani, Kazuki; Tabata, Minoru; Ueno, Hiroshi; Takagi, Kensuke; Higashimori, Akira; Watanabe, Yusuke; Otsuka, Toshiaki; Hayashida, Kentaro

doi:10.1016/j.ahj.2018.04.021

Cited by 55 publications

(39 citation statements)

References 22 publications

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“…Data analysis has recently appeared from a Japanese registry which has also suggested that GNRI has a prognostic value in TAVR [16]. Patient details were based on registry records and information on deaths were obtained from the treating hospital or by calling family members.…”

Section: Discussionmentioning

confidence: 99%

Nutritional risk index is a better predictor of early mortality than conventional nutritional markers after transcatheter aortic valve replacement: A prospective cohort study

et al. 2021

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Background: Nutritional risk index (NRI) has been shown to better predict survival than body mass index (BMI) or albumin after several cardiovascular interventions. Under assessment herein is whether NRI can have higher predictive value than conventional parameters for short-term survival after transcatheter aortic valve replacement (TAVR). Methods: A prospective cohort study was performed. In-hospital, 1-month and 3-month survival was evaluated. Since most patients undergoing TAVR are over 65, the NRI definition for a geriatric population (GNRI) was used. The impact of baseline BMI, albumin levels, and GNRI on in-hospital and short-term survival was assessed.

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Section: Discussionmentioning

confidence: 99%

Nutritional risk index is a better predictor of early mortality than conventional nutritional markers after transcatheter aortic valve replacement: A prospective cohort study

et al. 2021

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“…The significance of evaluating nutritional status has been gathering clinical attention in a wide range of diseased populations for its usefulness as a prognostic indicator. In the field of cardiovascular diseases, the association between malnutrition or poor nutritional status and adverse outcomes, in other words, an elevated risk of adverse outcomes in undernourished populations, has been reported in patients with coronary artery disease [13,19], heart failure [14,20], peripheral artery disease [21] patients who underwent coronary artery bypass graft surgery [22,23], valvular surgery [24], or trans arterial valve implantation (TAVI) [25]. In patients with critical situations, the adverse prognostic impact of the malnutrition on short-term in-hospital mortality has been evaluated in patients hospitalized in intensive care units (ICU) [1,2].…”

Section: Discussionmentioning

confidence: 99%

A Novel Nutritional Index Serves as A Useful Prognostic Indicator in Cardiac Critical Patients Requiring Mechanical Circulatory Support

et al. 2019

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Background: A poor nutritional status has been gathering intense clinical interest recently as it has been suggested to associate with adverse outcomes in patients in the intensive care unit (ICU). However, there is still no established nutritional index dominantly used in clinical practice. We have previously proposed a novel nutritional index, which can be calculated using serum levels of triglycerides, total cholesterol, and body weight (TCBI). In this study, to expand the application of TCBI for critical patients, we investigated the usefulness of TCBI to predict prognosis in hemodynamically unstable patients with percutaneously implantable mechanical circulatory support (MCS) devices in the ICU. Patients and Methods: This is a retrospective analysis of a multicenter registry consisting of three Juntendo University hospitals in Japan involving patients who received MCS devices, including intra-aortic balloon pumping (IABP) with or without veno-arterial extracorporeal membrane oxygenation (VA-ECMO), between 2012 and 2016 (n = 439). The median follow-up period was 298 days. Results: Spearman’s correlation coefficient between TCBI and the geriatric nutritional risk index (GNRI) was 0.44 (p < 0.0001), indicating a moderate positive correlation for these two variables. Unadjusted Kaplan–Meier analysis demonstrated reduced risks of all-cause and cardiovascular mortalities in patients with higher tertiles of TCBI. Furthermore, adjusted multivariate Cox proportional hazard analyses revealed that the highest tertile TCBI was an independent predictor for the reduced risk of all-cause mortality (hazard ratio (HR): 0.22, 95% confidence interval: 0.10–0.48, p < 0.0001) and cardiovascular mortality (0.20, 0.09–0.45, p < 0.0001). Conclusion: A novel and simple to calculate nutritional index, TCBI, can be applicable as a prognostic indicator in hemodynamically unstable patients requiring MCS devices.

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“…Comparisons of the baseline characteristics between the two cohorts were made using χ 2 tests for categorical variables and unpaired Student's t ‐test for continuous variables listed as mean values and Mann–Whitney U test for continuous variables listed as median values. We used the following variables as candidate predictors for incorporation into the risk prediction in conjunction with our previous reports 10‐12,14‐17 : sex, body mass index (BMI), Clinical Frailty Scale (CFS), New York Heart Association (NYHA) class, history of prior cardiac surgery, serum albumin concentration, estimated glomerular filtration rate (eGFR), presence of pulmonary disease, STS score, atrial fibrillation (AF), peripheral artery disease (PAD), liver disease, and active cancer. In addition, echocardiographic parameters such as left ventricle ejection fraction (LVEF) and stroke volume index were also considered.…”

Section: Methodsmentioning

confidence: 99%

Clinical risk model for predicting 1‐year mortality after transcatheter aortic valve replacement

Yamamoto

Otsuka

Shimura

et al. 2020

Cathet Cardio Intervent

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Objectives Estimating 1‐year life expectancy is an essential factor when evaluating appropriate indicators for transcatheter aortic valve replacement (TAVR). Background It is clinically useful in developing a reliable risk model for predicting 1‐year mortality after TAVR. Methods We evaluated 2,588 patients who underwent TAVR using data from the Optimized CathEter vAlvular iNtervention (OCEAN) Japanese multicenter registry from October 2013 to May 2017. The 1‐year clinical follow‐up was achieved by 99.5% of the entire population (n = 2,575). Patients were randomly divided into two cohorts: the derivation cohort (n = 1,931, 75% of the study population) and the validation cohort (n = 644). Considerable clinical variables including individual patient's comorbidities and frailty markers were used for predicting 1‐year mortality following TAVR. Results In the derivation cohort, a multivariate logistic regression analysis demonstrated that sex, body mass index, Clinical Frailty Scale, atrial fibrillation, peripheral artery disease, prior cardiac surgery, serum albumin, renal function as estimated glomerular filtration rate, and presence of pulmonary disease were independent predictors of 1‐year mortality after TAVR. Using these variables, a risk prediction model was constructed to estimate the 1‐year risk of mortality after TAVR. In the validation cohort, the risk prediction model revealed high discrimination ability and acceptable calibration with area under the curve of 0.763 (95% confidence interval, 0.728–0.795, p < .001) in the receiver operating characteristics curve analysis and a Hosmer–Lemeshow χ2 statistic of 5.96 (p = .65). Conclusions This risk prediction model for 1‐year mortality may be a reliable tool for risk stratification and identification of adequate candidates in patients undergoing TAVR.

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Importance of Geriatric Nutritional Risk Index assessment in patients undergoing transcatheter aortic valve replacement

Cited by 55 publications

References 22 publications

Nutritional risk index is a better predictor of early mortality than conventional nutritional markers after transcatheter aortic valve replacement: A prospective cohort study

Nutritional risk index is a better predictor of early mortality than conventional nutritional markers after transcatheter aortic valve replacement: A prospective cohort study

A Novel Nutritional Index Serves as A Useful Prognostic Indicator in Cardiac Critical Patients Requiring Mechanical Circulatory Support

Clinical risk model for predicting 1‐year mortality after transcatheter aortic valve replacement

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