Nutritional status and risk of all-cause mortality in patients undergoing transcatheter aortic valve replacement assessment using the geriatric nutritional risk index and the controlling nutritional status score.

Lee, Kyusup; Ahn, Jung-Min; Kang, Do-Yoon; Ko, Euihong; Kwon, Osung; Lee, Pil Hyung; Lee, Seung-Whan; Kim, Dae-Hee; Kim, Ho Jin; Kim, Joon Bum; Choo, Suk Jung; Park, Duk-Woo; Park, Seung-Jung
Clinical research in cardiology : official journal of the German Cardiac Society
2019May ; 305 ( 5 ) :.
저자 상세정보
Lee, Kyusup - Department of Cardiology, Daejeon St Mary's Hospital, The Catholic University of Korea, Daejeon, South Korea.
Ahn, Jung-Min - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
Kang, Do-Yoon - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
Ko, Euihong - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
Kwon, Osung - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
Lee, Pil Hyung - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
Lee, Seung-Whan - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
Kim, Dae-Hee - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
Kim, Ho Jin - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Kim, Joon Bum - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Choo, Suk Jung - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Park, Duk-Woo - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea. dwpark@amc.seoul.kr.
Park, Seung-Jung - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
ABSTRACT
BACKGROUND: Nutritional status, a key marker of patient frailty, is an important prognostic factor after transcatheter aortic valve replacement (TAVR). Few investigations have evaluated the clinical usefulness of nutritional assessment tools for predicting the risk of mortality following TAVR.

METHODS: A total of 412 patients with symptomatic severe AS who underwent TAVR between March 2010 and August 2017 were stratified into subgroups by their Geriatric Nutritional Risk Index [GNRI, low ??98 vs. high >?98 (better nutritional status)] and Controlling Nutritional Status (CONUT) score [low ??3 vs. high ??4; (poorer nutritional status)]. The primary study outcome was all-cause mortality at 1?year.

RESULTS: Patients with low GNRI score showed a significantly higher 1-year mortality rate as compared to those with high GNRI score (13.0% vs. 3.2%, respectively; P?=?0.001). Similarly, patients with high CONUT score had a significantly higher rate of 1-year mortality than those with low CONUT score (15.7% vs. 6.2%, respectively; P?=?0.005). However, in multivariable Cox proportional-hazards models, low GNRI was the only independent predictor of mortality (adjusted hazard ratio, 3.77; 95% confidence interval 1.54-9.20; P?=?0.004). Overall, integration of GNRI into conventional risk models of STS score or logistic EuroSCORE resulted in improved predictive value for mortality measured by the net reclassification improvement and the integrated discrimination improvement.

CONCLUSIONS: In patients undergoing TAVR, low GNRI (but not high CONUT score) was independently associated with a higher risk of 1-year mortality. Further research is required to determine whether nutritional screening and management can improve clinical outcomes in patients undergoing TAVR.
keyword
Aortic stenosis; Mortality; Nutritional status; Transaortic valve replacement
링크

주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
Low GNRI (but not high CONUT score) was independently associated with a higher risk of 1-year mortality.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
DOI
10.1007/s00392-019-01497-9
KCD코드
ICD 03
건강보험코드