Normal Geriatric Nutritional Risk Index is Associated with Rehospitalization After Orthotopic Heart Transplant

Abstract

<h3>Purpose</h3> Malnutrition has been associated with poor clinical outcomes in patients with coronary artery disease who undergo percutaneous coronary intervention and in patients with heart failure. This study aims to assess the impact of the geriatric nutritional risk index (GNRI) on clinical outcomes in patients undergoing orthotopic heart transplantation (OHT). <h3>Methods</h3> Consecutive patients undergoing OHT were included from 2018 to present after the change in UNOS listing criteria. Patients 60 years-old or greater were included in this study and those that survived to discharge were included. Fifty-seven patients were identified. Geriatric nutritional risk index (GNRI) was calculated using pre-procedure body mass index (BMI) and serum albumin for each patient. Patients were stratified into two groups: GNRI <98 (low GNRI) and >98 (normal GNRI). Primary outcomes were mortality, stroke, heart failure readmissions, and all-cause readmissions at one year. <h3>Results</h3> The mean age of study subjects was 66.0 years. Seventy-seven percent of patients were male. Fifteen patients were included in the low GNRI group. Patients with normal GNRI were more likely to be readmitted (p = 0.114), transplant related readmissions (p = 0.131), and significantly more infection related readmissions (p = 0.026). <h3>Conclusion</h3> Normal nutritional status as designated by a GNRI of >98 was not predictive of fitness. However, was related with higher rates of readmission as compared to those with low GNRI—a paradox as compared to prior literature. Although, GNRI is well established in percutaneous coronary intervention, heart failure, and aortic stenosis it appears that this does not hold true in patients undergoing OHT.