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Nutritional risk index as a predictor of mortality in acutely decompensated heart failure

 Jae Yeong Cho  ;  Kye Hun Kim  ;  Hyun-Jai Cho  ;  Hae-Young Lee  ;  Jin-Oh Choi  ;  Eun-Seok Jeon  ;  Sang Eun Lee  ;  Min-Seok Kim  ;  Jae-Joong Kim  ;  Kyung-Kuk Hwang  ;  Shung Chull Chae  ;  Sang Hong Baek  ;  Seok-Min Kang  ;  Dong-Ju Choi  ;  Byung-Su Yoo  ;  Youngkeun Ahn  ;  Hyun-Young Park  ;  Myeong-Chan Cho  ;  Byung-Hee Oh 
 PLOS ONE, Vol.13(12) : e0209088, 2018 
Journal Title
Issue Date
Aged ; Cohort Studies ; Female ; Heart Failure/mortality* ; Humans ; Male ; Nutrition Assessment* ; ROC Curve ; Risk Assessment
BACKGROUND: We investigated the role of nutritional risk index (NRI) in predicting 1-year mortality in patients with acute decompensated heart failure (ADHF). METHODS: Among 5,625 cohort patients enrolled in Korean Acute Heart Failure (KorAHF) Registry, a total of 5,265 patients who were possible to calculate NRI [NRI = (1.519 x serum albumin [g/dl]) + (41.7 x weight [kg]/ideal body weight [kg])] were enrolled. The patients were divided into 4 groups according to the NRI quartile; Q1 <89 (n = 1121, 69.9 ± 14.5 years, 632 males), Q2 89-95 (n = 1234, 69.7 ± 14.4 years, 677 males), Q3 95-100 (n = 1199, 68.8 ± 14.0 years, 849 males), Q4 >100 (n = 1711, 65.6 ± 14.5 years, 779 males). Primary end-point was all-cause mortality at 1-year clinical follow-up. RESULTS: The 1-year mortality was significantly increased as the NRI quartile decreased, and the lowest NRI quartile was associated with the highest 1-year mortality (Q1: 27.5% vs. Q2: 20.9% vs. Q3: 12.9% vs. Q4: 8.7%, linear p <0.001). On Kaplan-Meier survival analysis, the significant inter-quartile difference was observed (p <0.001 for all). In multivariate analysis using Cox proportional hazard regression, the lowest NRI quartile was an independent predictor of 1-year mortality in patients with ADHF. CONCLUSIONS: Poor nutritional status as assessed by NRI and quartile grading of NRI was associated with 1-year mortality in Korean patients with ADHF. The assessment of nutritional status by NRI may provide additional prognostic information and thus would be useful in the risk stratification of the patients with ADHF.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
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