Abstract
OBJECTIVES:Geriatric nutritional risk index (GNRI) might predict the all-cause mortality in patients with heart failure (HF). We performed a meta-analysis to evaluate the correlation between GNRI and all-cause mortality in patients with HF.METHODS:We searched the PubMed, Medline, Cochrane Library, and Embase databases for clinical trials investigating the association between GNRI and all-cause mortality in patients with HF, having the primary endpoint as all-cause mortality.RESULTS:In total, nine studies involving 7,659 subjects were included in the systematic review and meta-analysis. The results indicated that major risk and moderate risk GNRI (GNRI<92) was associated with an increased risk of all-cause mortality in elderly patients with HF (hazard ratios [HR] 1.59, 95% confidence intervals [CI] 1.37-1.85). Low risk GNRI (GNRI<98) group predicted all-cause mortality in elderly HF patients (HR 1.56, 95%CI 1.12-2.18) when compared with the high GNRI value group. A subgroup analysis indicated that the relationship between GNRI and HF might differ based on the subtype of heart failure.CONCLUSIONS:GNRI is a simple and well-established nutritional assessment tool to predict all-cause mortality in patients with HF.
Highlights
Heart failure (HF) is associated with high morbidity and mortality
The prognostic nutrition status (PNI), controlling nutrition status (CONUT), and geriatric nutritional risk index (GNRI) have been studied, and the GNRI is reported to be very important in elderly patients
The analysis indicated that the low GNRI group had higher all-cause mortality in HF (HR 1.56, 95%confidence intervals (CIs) 1.12-2.18, compared to the high GNRI group (Figure 3)
Summary
1–2% of adults have HF, and the incidence increases to 10% among people aged above 70 years [1,2,3,4]. The all-cause mortality rate has been reported to be 5.0–30.0% in 12 months, and the one-year hospitalization rates are 18.9–65.0% [5,6,7]. Some studies indicated that malnutrition was common in patients with HF, and it might be useful in predicting the all-cause mortality, risk of cardiovascular (CV) events, and hospitalization for HF [11,12,13,14,15,16]. The prognostic nutrition status (PNI), controlling nutrition status (CONUT), and geriatric nutritional risk index (GNRI) have been studied, and the GNRI is reported to be very important in elderly patients.
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