Association of the geriatric nutritional risk index with poor outcomes in patients with coronary revascularization: a cohort study
BackgroundPoor nutritional status may affect outcomes after coronary revascularization, but the association between nutritional status and outcomes in patients undergoing coronary revascularization has not been fully evaluated. This study was based on the MIMIC-IV database to analyze the impact of b...
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Frontiers Media S.A.
2024-12-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1442957/full |
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| author | Beili Xie Yue Shi Mingwang Liu Zhidie Jin Wei Wen Yuxin Yan Mengjie Gao Lulian Jiang Lin Yang Jiangang Liu Dazhuo Shi Dazhuo Shi Fuhai Zhao Fuhai Zhao |
| author_facet | Beili Xie Yue Shi Mingwang Liu Zhidie Jin Wei Wen Yuxin Yan Mengjie Gao Lulian Jiang Lin Yang Jiangang Liu Dazhuo Shi Dazhuo Shi Fuhai Zhao Fuhai Zhao |
| author_sort | Beili Xie |
| collection | DOAJ |
| description | BackgroundPoor nutritional status may affect outcomes after coronary revascularization, but the association between nutritional status and outcomes in patients undergoing coronary revascularization has not been fully evaluated. This study was based on the MIMIC-IV database to analyze the impact of baseline nutritional status on poor outcomes in patients with coronary revascularization.MethodsPatients with coronary revascularization were screened from the MIMIC-IV database. A geriatric nutritional risk index (GNRI) was calculated and used to divide patients into 4 groups: no malnutrition (Q4: ≥96.79), mild malnutrition (Q3: 90.85–96.78), moderate malnutrition (Q2: 86.37–90.84), and severe malnutrition (Q1: 86.37). The primary outcome measure was 28-day mortality, and the secondary outcome measures were AKI and length of hospital stay. Cox proportional hazards model, Kaplan-Meier survival analysis, restricted cubic spline (RCS), and multiple linear regression model were used for statistical analysis, respectively, to ensure the robustness of study results.ResultsA total of 1,168 patients with coronary revascularization were included. The GNRI demonstrated a significant association with 28-day mortality in patients undergoing coronary revascularization. As a continuous variable, the GNRI exhibited a notable inverse correlation with mortality across unadjusted, partially adjusted, and fully adjusted Cox regression models [hazard ratios (HRs): 0.93, 0.94, 0.96, respectively; all P < 0.001]. When considered as a categorical variable, a low GNRI (first quartile, Q1) was significantly associated with elevated mortality risks (HRs: 2.64, 2.30, 1.82 in the unadjusted, partially adjusted, and fully adjusted models, respectively; all P < 0.05). Subgroup analysis revealed a more pronounced association in patients under 65 years of age (P for interaction = 0.014). Furthermore, reduced GNRI levels were also associated with an increased incidence of AKI and extended hospital lengths of stay.ConclusionGNRI is associated with prognosis in patients with coronary revascularization. Patients with lower GNRI had higher 28-day mortality, greater risk of AKI, and longer hospital stays. |
| format | Article |
| id | doaj-art-51d513de93054deaa6a2b823c4e558ee |
| institution | OA Journals |
| issn | 2297-055X |
| language | English |
| publishDate | 2024-12-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-51d513de93054deaa6a2b823c4e558ee2025-08-20T02:00:07ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2024-12-011110.3389/fcvm.2024.14429571442957Association of the geriatric nutritional risk index with poor outcomes in patients with coronary revascularization: a cohort studyBeili Xie0Yue Shi1Mingwang Liu2Zhidie Jin3Wei Wen4Yuxin Yan5Mengjie Gao6Lulian Jiang7Lin Yang8Jiangang Liu9Dazhuo Shi10Dazhuo Shi11Fuhai Zhao12Fuhai Zhao13Cardiovascular Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaCardiovascular Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaCardiovascular Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaCardiovascular Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaCardiovascular Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaGraduate School of Beijing University of Chinese Medicine, Xiyuan Hospital, Beijing, ChinaGraduate School of Beijing University of Chinese Medicine, Xiyuan Hospital, Beijing, ChinaGraduate School of Beijing University of Chinese Medicine, Xiyuan Hospital, Beijing, ChinaCardiovascular Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaCardiovascular Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaCardiovascular Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaNational Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Beijing, ChinaCardiovascular Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaNational Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Beijing, ChinaBackgroundPoor nutritional status may affect outcomes after coronary revascularization, but the association between nutritional status and outcomes in patients undergoing coronary revascularization has not been fully evaluated. This study was based on the MIMIC-IV database to analyze the impact of baseline nutritional status on poor outcomes in patients with coronary revascularization.MethodsPatients with coronary revascularization were screened from the MIMIC-IV database. A geriatric nutritional risk index (GNRI) was calculated and used to divide patients into 4 groups: no malnutrition (Q4: ≥96.79), mild malnutrition (Q3: 90.85–96.78), moderate malnutrition (Q2: 86.37–90.84), and severe malnutrition (Q1: 86.37). The primary outcome measure was 28-day mortality, and the secondary outcome measures were AKI and length of hospital stay. Cox proportional hazards model, Kaplan-Meier survival analysis, restricted cubic spline (RCS), and multiple linear regression model were used for statistical analysis, respectively, to ensure the robustness of study results.ResultsA total of 1,168 patients with coronary revascularization were included. The GNRI demonstrated a significant association with 28-day mortality in patients undergoing coronary revascularization. As a continuous variable, the GNRI exhibited a notable inverse correlation with mortality across unadjusted, partially adjusted, and fully adjusted Cox regression models [hazard ratios (HRs): 0.93, 0.94, 0.96, respectively; all P < 0.001]. When considered as a categorical variable, a low GNRI (first quartile, Q1) was significantly associated with elevated mortality risks (HRs: 2.64, 2.30, 1.82 in the unadjusted, partially adjusted, and fully adjusted models, respectively; all P < 0.05). Subgroup analysis revealed a more pronounced association in patients under 65 years of age (P for interaction = 0.014). Furthermore, reduced GNRI levels were also associated with an increased incidence of AKI and extended hospital lengths of stay.ConclusionGNRI is associated with prognosis in patients with coronary revascularization. Patients with lower GNRI had higher 28-day mortality, greater risk of AKI, and longer hospital stays.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1442957/fullnutritional risk index in the elderlycoronary revascularizationmortalityacute kidney injuryMIMIC-IV databasecohort study |
| spellingShingle | Beili Xie Yue Shi Mingwang Liu Zhidie Jin Wei Wen Yuxin Yan Mengjie Gao Lulian Jiang Lin Yang Jiangang Liu Dazhuo Shi Dazhuo Shi Fuhai Zhao Fuhai Zhao Association of the geriatric nutritional risk index with poor outcomes in patients with coronary revascularization: a cohort study Frontiers in Cardiovascular Medicine nutritional risk index in the elderly coronary revascularization mortality acute kidney injury MIMIC-IV database cohort study |
| title | Association of the geriatric nutritional risk index with poor outcomes in patients with coronary revascularization: a cohort study |
| title_full | Association of the geriatric nutritional risk index with poor outcomes in patients with coronary revascularization: a cohort study |
| title_fullStr | Association of the geriatric nutritional risk index with poor outcomes in patients with coronary revascularization: a cohort study |
| title_full_unstemmed | Association of the geriatric nutritional risk index with poor outcomes in patients with coronary revascularization: a cohort study |
| title_short | Association of the geriatric nutritional risk index with poor outcomes in patients with coronary revascularization: a cohort study |
| title_sort | association of the geriatric nutritional risk index with poor outcomes in patients with coronary revascularization a cohort study |
| topic | nutritional risk index in the elderly coronary revascularization mortality acute kidney injury MIMIC-IV database cohort study |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1442957/full |
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