Abstract 14739: Malnutrition Assessed by Geriatric Nutritional Index Predicts Mode of Death in Patients Admitted With Acute Decompensated Heart Failure
Backgrounds: Malnutrition is associated with increased mortality risk in patients with heart failure. Prediction of mode of death (sudden cardiac death (SCD) and pump failure death (PFD)) in patients with heart failure may facilitate decisions about specific medications or devices. However, there is no information available on the prognostic significance of malnutrition in patients admitted with acute decompensated heart failure (ADHF), from the viewpoint o f mode of death.
Methods and Results: We studied 305 consecutive pts admitted with ADHF and discharged with survival. Nutritional status was evaluated by geriatric nutritional risk index (GNRI) which was calculated as follows: 14.89 x serum albumin (g/dl) + 41.7 x body mass index/22. During a follow-up period of 4.4±3.3 yrs, 33 patients had SCD and 27 patients had PFD. At multivariate Cox analysis, GNRI at discharge (p=0.0035) was significantly associated with SCD, independently of systolic blood pressure (SBP) and estimated glomerular filtration rate. Furthermore, GNRI at discharge (p=0.04) was also significantly associated with PFD, independently of SBP, serum sodium and prior heart failure hospitalization. Receiver-operator curve analysis revealed that GNRI of 88 was a fair discriminator for SCD (AUC 0.658(95%CI 0.559-0.757)) and PFD (AUC 0.684(95%CI 0.588-0.780)). Patients with low GNRI(<88) had significantly a higher risk of not only SCD (20% vs 8%, p<0.0001, adjusted HR: 2.5 (95%CI 1.2-5.4)) but also PFD (17% vs 6%, p=0.0001, adjusted HR: 2.6 (95%CI 1.1-6.3)), compared to those with high GNRI(≥88) .
Conclusion: Malnutrition assessed by GNRI might predict not only sudden cardiac death but also pump failure death in patients admitted with ADHF.
- © 2013 by American Heart Association, Inc.