摘要
目的评估老年营养风险指数是否有助于预测老年急性失代偿性心力衰竭(ADHF)住院患者的长期预后。方法回顾性研究2013年6月至2018年6月在我院连续入院的年龄在65岁以上老年ADHF患者的病历资料。评估老年营养风险指数(GNRI),GNRI<92分被定义为营养不良。主要观察终点是比较低GNRI(<92分)组和高GNRI(≥92分)组2年内全因死亡。结果47.67%的患者GNRI<92分,与GNRI≥92组比较,GNRI<92组体质指数(BMI)显著降低[(24.22±4.68)kg/m2比(18.53±2.52)kg/m2,P<0.01];B型钠尿肽、C反应蛋白、血红蛋白显著降低(P<0.01);Kaplan-Meier生存分析显示,GNRI<92组患者全因死亡率显著高于GNRI≥92组(HR=2.667,95%CI:1.527~4.651,P<0.001)。多因素Cox比例风险回归分析显示:低GNRI(HR=0.947;95%CI:0.920~0.975,P<0.001)和年龄(HR=1.064;95%CI:1.026~1.012,P<0.001),是全因死亡率的强独立预测因子。结论出院时应用GNRI进行营养评估有助于预测老年ADHF患者的长期预后。
Objective To evaluate whether the geriatric nutritional risk index(GNRI)can help predict the long-term prognosis in aged hospitalized patients with acute decompensated heart failure(ADHF).Methods The elderly hospitalized ADHF patients over 65 years of age who were admitted to our hospital between June 2013 to June 2018 were selected.To assess the geriatric nutritional risk index(GNRI).GNRI score<92 was defined as malnutrition.The primary endpoints were all-cause mortality within 2 years compared between the low GNRI(<92)group and the high GNRI(≥92)group.Result A total of 47.67%of patients had GNRI<92 points.Compared with GNRI≥92 group,body mass index(BMI)in GNRI<92 group was significantly decreased[(24.22±4.68)kg/m2 vs.(18.53±2.52)kg/m2,P<0.01];B-type natriuretic peptide,C-reactive protein and hemoglobin were significantly decreased(P<0.01).Kaplan-Meier survival analysis showed that the all-cause mortality in GNRI<92 group was significantly higher than that in GNRI≥92 group(HR=2.667,95%CI:1.527-4.651,P<0.001).Multivariate Cox proportional risk regression analysis showed that low GNRI(HR=0.947;95%CI:0.920-0.975,P<0.001)and age(HR=1.064;95%CI:1.026-1.012,P<0.001)were strong independent predictor of all-cause mortality.Conclusion Nutritional assessment with GNRI at discharge is helpful to predict the long-term prognosis of aged ADHF patients.
作者
尹巧香
张伟
张蓝宁
靳英
段景琪
曹艳杰
Yin Qiaoxiang;Zhang Wei;Zhang Lanning;Ji Ying;Duan Jingqi;Cao Yanjie(Department of Geriatrics,Air Force Medical Center,PLA,Beijing 100142,China)
出处
《中国临床保健杂志》
CAS
2021年第2期243-247,共5页
Chinese Journal of Clinical Healthcare
基金
军委后勤保障部卫生局科研项目(18BJZ07)。
关键词
心力衰竭
营养评价
营养不良
危险性评估
预后
老年人
Heart failure
Nutrition assessment
Malnutrition
Risk assessment
Prognosis
Aged
