Importance of Geriatric Nutritional Risk Index assessment in patients undergoing transcatheter aortic valve replacement

on the behalf of OCEAN-TAVI investigators

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Nutritional condition is one marker of patients’ frailty. The Geriatric Nutritional Risk Index (GNRI) is a well-known marker of nutritional status. This study sought to assess the clinical outcomes of GNRI after transcatheter aortic valve replacement (TAVR). Methods: We evaluated the GNRI value of 1,613 patients who underwent TAVR using data from a Japanese multicenter registry. According to baseline GNRI, patients were classified into 3 groups: GNRI ≥92 (n = 1,085; 67.3%), GNRI 82-92 (n = 396; 24.6%), and GNRI ≤82 (n = 132; 8.2%). Baseline characteristics, procedural outcomes, and cumulative mortality rates were compared. In addition, GNRI correlations with other frailty components (gait speed, grip strength, and Clinical Frailty Scale) and Society of Thoracic Surgeons (STS) score were also evaluated. Results: Significantly increased mortality rates were observed across the 3 groups at 30 days (0.9%, 2.3%, and 6.8%, respectively; P <.001) and 1 year (6.5%, 16.4%, and 36.4%, respectively; P <.001). Both GNRI 82-92 and GNRI ≤82 (as a reference for GNRI ≥92) were independently associated with increased midterm mortality in the Cox regression multivariate model (hazard ratio: 1.97, 3.60; 95% confidence interval: 1.37-2.84, 2.30-5.64; P <.001, P <.001, respectively). The GNRI value was significantly correlated with gait speed (Spearman ρ = −0.15, P <.001), grip strength (ρ = 0.25, P <.001), Clinical Frailty Scale (ρ = −0.24, P <.001), and STS score (ρ = −0.29, P <.001). Conclusions: GNRI is related to both frailty components and the STS score and is an important surrogate marker for predicting worse clinical outcomes after TAVR. Assessment of the GNRI may be considered when deciding on TAVR.

Original languageEnglish
Pages (from-to)68-75
Number of pages8
JournalAmerican Heart Journal
Volume202
DOIs
Publication statusPublished - 2018 Aug 1

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Nutrition Assessment
Geriatrics
Hand Strength
Transcatheter Aortic Valve Replacement
Mortality
Thorax
Geriatric Assessment
Nutritional Status
Proportional Hazards Models
Registries

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Importance of Geriatric Nutritional Risk Index assessment in patients undergoing transcatheter aortic valve replacement. / on the behalf of OCEAN-TAVI investigators.

In: American Heart Journal, Vol. 202, 01.08.2018, p. 68-75.

Research output: Contribution to journalArticle

@article{8ad0618d4b854391bfdfea56feec4c66,
title = "Importance of Geriatric Nutritional Risk Index assessment in patients undergoing transcatheter aortic valve replacement",
abstract = "Background: Nutritional condition is one marker of patients’ frailty. The Geriatric Nutritional Risk Index (GNRI) is a well-known marker of nutritional status. This study sought to assess the clinical outcomes of GNRI after transcatheter aortic valve replacement (TAVR). Methods: We evaluated the GNRI value of 1,613 patients who underwent TAVR using data from a Japanese multicenter registry. According to baseline GNRI, patients were classified into 3 groups: GNRI ≥92 (n = 1,085; 67.3{\%}), GNRI 82-92 (n = 396; 24.6{\%}), and GNRI ≤82 (n = 132; 8.2{\%}). Baseline characteristics, procedural outcomes, and cumulative mortality rates were compared. In addition, GNRI correlations with other frailty components (gait speed, grip strength, and Clinical Frailty Scale) and Society of Thoracic Surgeons (STS) score were also evaluated. Results: Significantly increased mortality rates were observed across the 3 groups at 30 days (0.9{\%}, 2.3{\%}, and 6.8{\%}, respectively; P <.001) and 1 year (6.5{\%}, 16.4{\%}, and 36.4{\%}, respectively; P <.001). Both GNRI 82-92 and GNRI ≤82 (as a reference for GNRI ≥92) were independently associated with increased midterm mortality in the Cox regression multivariate model (hazard ratio: 1.97, 3.60; 95{\%} confidence interval: 1.37-2.84, 2.30-5.64; P <.001, P <.001, respectively). The GNRI value was significantly correlated with gait speed (Spearman ρ = −0.15, P <.001), grip strength (ρ = 0.25, P <.001), Clinical Frailty Scale (ρ = −0.24, P <.001), and STS score (ρ = −0.29, P <.001). Conclusions: GNRI is related to both frailty components and the STS score and is an important surrogate marker for predicting worse clinical outcomes after TAVR. Assessment of the GNRI may be considered when deciding on TAVR.",
author = "{on the behalf of OCEAN-TAVI investigators} and Kenichi Shibata and Masanori Yamamoto and Seiji Kano and Yutaka Koyama and Tetsuro Shimura and Ai Kagase and Sumio Yamada and Toshihiro Kobayashi and Norio Tada and Toru Naganuma and Motoharu Araki and Futoshi Yamanaka and Shinichi Shirai and Kazuki Mizutani and Minoru Tabata and Hiroshi Ueno and Kensuke Takagi and Akihiro Higashimori and Yusuke Watanabe and Toshiaki Otsuka and Kentaro Hayashida",
year = "2018",
month = "8",
day = "1",
doi = "10.1016/j.ahj.2018.04.021",
language = "English",
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pages = "68--75",
journal = "American Heart Journal",
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T1 - Importance of Geriatric Nutritional Risk Index assessment in patients undergoing transcatheter aortic valve replacement

AU - on the behalf of OCEAN-TAVI investigators

AU - Shibata, Kenichi

AU - Yamamoto, Masanori

AU - Kano, Seiji

AU - Koyama, Yutaka

AU - Shimura, Tetsuro

AU - Kagase, Ai

AU - Yamada, Sumio

AU - Kobayashi, Toshihiro

AU - Tada, Norio

AU - Naganuma, Toru

AU - Araki, Motoharu

AU - Yamanaka, Futoshi

AU - Shirai, Shinichi

AU - Mizutani, Kazuki

AU - Tabata, Minoru

AU - Ueno, Hiroshi

AU - Takagi, Kensuke

AU - Higashimori, Akihiro

AU - Watanabe, Yusuke

AU - Otsuka, Toshiaki

AU - Hayashida, Kentaro

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Background: Nutritional condition is one marker of patients’ frailty. The Geriatric Nutritional Risk Index (GNRI) is a well-known marker of nutritional status. This study sought to assess the clinical outcomes of GNRI after transcatheter aortic valve replacement (TAVR). Methods: We evaluated the GNRI value of 1,613 patients who underwent TAVR using data from a Japanese multicenter registry. According to baseline GNRI, patients were classified into 3 groups: GNRI ≥92 (n = 1,085; 67.3%), GNRI 82-92 (n = 396; 24.6%), and GNRI ≤82 (n = 132; 8.2%). Baseline characteristics, procedural outcomes, and cumulative mortality rates were compared. In addition, GNRI correlations with other frailty components (gait speed, grip strength, and Clinical Frailty Scale) and Society of Thoracic Surgeons (STS) score were also evaluated. Results: Significantly increased mortality rates were observed across the 3 groups at 30 days (0.9%, 2.3%, and 6.8%, respectively; P <.001) and 1 year (6.5%, 16.4%, and 36.4%, respectively; P <.001). Both GNRI 82-92 and GNRI ≤82 (as a reference for GNRI ≥92) were independently associated with increased midterm mortality in the Cox regression multivariate model (hazard ratio: 1.97, 3.60; 95% confidence interval: 1.37-2.84, 2.30-5.64; P <.001, P <.001, respectively). The GNRI value was significantly correlated with gait speed (Spearman ρ = −0.15, P <.001), grip strength (ρ = 0.25, P <.001), Clinical Frailty Scale (ρ = −0.24, P <.001), and STS score (ρ = −0.29, P <.001). Conclusions: GNRI is related to both frailty components and the STS score and is an important surrogate marker for predicting worse clinical outcomes after TAVR. Assessment of the GNRI may be considered when deciding on TAVR.

AB - Background: Nutritional condition is one marker of patients’ frailty. The Geriatric Nutritional Risk Index (GNRI) is a well-known marker of nutritional status. This study sought to assess the clinical outcomes of GNRI after transcatheter aortic valve replacement (TAVR). Methods: We evaluated the GNRI value of 1,613 patients who underwent TAVR using data from a Japanese multicenter registry. According to baseline GNRI, patients were classified into 3 groups: GNRI ≥92 (n = 1,085; 67.3%), GNRI 82-92 (n = 396; 24.6%), and GNRI ≤82 (n = 132; 8.2%). Baseline characteristics, procedural outcomes, and cumulative mortality rates were compared. In addition, GNRI correlations with other frailty components (gait speed, grip strength, and Clinical Frailty Scale) and Society of Thoracic Surgeons (STS) score were also evaluated. Results: Significantly increased mortality rates were observed across the 3 groups at 30 days (0.9%, 2.3%, and 6.8%, respectively; P <.001) and 1 year (6.5%, 16.4%, and 36.4%, respectively; P <.001). Both GNRI 82-92 and GNRI ≤82 (as a reference for GNRI ≥92) were independently associated with increased midterm mortality in the Cox regression multivariate model (hazard ratio: 1.97, 3.60; 95% confidence interval: 1.37-2.84, 2.30-5.64; P <.001, P <.001, respectively). The GNRI value was significantly correlated with gait speed (Spearman ρ = −0.15, P <.001), grip strength (ρ = 0.25, P <.001), Clinical Frailty Scale (ρ = −0.24, P <.001), and STS score (ρ = −0.29, P <.001). Conclusions: GNRI is related to both frailty components and the STS score and is an important surrogate marker for predicting worse clinical outcomes after TAVR. Assessment of the GNRI may be considered when deciding on TAVR.

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JO - American Heart Journal

JF - American Heart Journal

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