Abstract 13076: Geriatric Nutritional Risk Index and Sarcopenia in Patients Undergoing Cardiac Transplantation

Abstract

Background: The Geriatric Nutrition Risk Index (GNRI) is a simple nutritional assessment tool used in elderly patients. Sarcopenia, defined as reduced muscle mass strength, is widely prevalent in patients with advanced heart failure, and has been associated with worse clinical outcomes including post-transplant infections and mortality but is not routinely assessed. The relationship between GNRI and sarcopenia in advanced heart failure patients undergoing cardiac transplantation has not been well-established. Aims/Hypotheses: The primary outcome was to determine if GNRI was associated with sarcopenia as diagnosed using pectoralis muscle area index. We hypothesize that patients with a higher nutritional risk (GNRI < 92) will have higher rates of sarcopenia. Methods: Patients who underwent cardiac transplantation from January 2018 to June 2022 and who underwent preoperative chest CT scans were included. GNRI was calculated using albumin, height and weight on the day of transplant. Previous literature has defined malnutrition status as a GNRI < 92. The primary outcome was sarcopenia which was diagnosed as pectoralis muscle area index in the lowest sex-specific tertile. Results: 172 patients were included in the primary analysis and were stratified into high (GNRI<92) and low (GNRI>92) nutritional risk. Patients with high nutritional risk had a lower BMI than those with low nutritional risk. Patients with high nutritional risk were more likely to meet criteria for sarcopenia than those with low risk (56.5% vs 28.9%, p=0.02). Additionally, patients with high nutritional risk had a longer hospital length of stay at their index hospitalization than patients with low nutritional risk (29 vs 22 days, p=0.03). There were no significant differences by nutritional risk in outcomes of rehospitalizations, days alive and out of the hospital, or death. Conclusions: Lower GNRI (higher nutritional risk) was associated with a greater prevalence of sarcopenia in patients undergoing cardiac transplantation. This index may represent a simple screening tool utilizing readily available data to ascertain sarcopenia in patients with advanced heart failure.