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

doi:10.1371/journal.pone.0209088

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

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Abstract

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.

Original language	English
Article number	e0209088
Journal	PloS one
Volume	13
Issue number	12
DOIs	https://doi.org/10.1371/journal.pone.0209088
Publication status	Published - 2018 Dec

Bibliographical note

Funding Information:
The KorAHF registry was supported by Research of Korea Centers for Disease Control and Prevention [2010-E63003-00, 2011-E63002-00, 2012-E63005-00, 2013-E63003-00, 2013-E63003-01, 2013-E63003-02, 2016-ER6303-00, 2016-ER6303-01]. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The KorAHF registry was supported by Research of Korea Centers for Disease Control and Prevention [2010-E63003-00, 2011-E63002-00, 2012-E63005-00, 2013-E63003-00, 2013-E63003-01, 2013-E63003-02, 2016-ER6303-00, 2016-ER6303-01].

Publisher Copyright:
© 2018 Cho et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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10.1371/journal.pone.0209088

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Cho, J. Y., Kim, K. H., Cho, H. J., Lee, H. Y., Choi, J. O., Jeon, E. S., Lee, S. E., Kim, M. S., Kim, J. J., Hwang, K. K., Chae, S. C., Baek, S. H., Kang, S. M., Choi, D. J., Yoo, B. S., Ahn, Y., Park, H. Y., Cho, M. C., & Oh, B. H. (2018). Nutritional risk index as a predictor of mortality in acutely decompensated heart failure. PloS one, 13(12), Article e0209088. https://doi.org/10.1371/journal.pone.0209088

@article{8dd0c480cbc744ff80baf7762d059c69,

title = "Nutritional risk index as a predictor of mortality in acutely decompensated heart failure",

abstract = "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.",

author = "Cho, {Jae Yeong} and Kim, {Kye Hun} and Cho, {Hyun Jai} and Lee, {Hae Young} and Choi, {Jin Oh} and Jeon, {Eun Seok} and Lee, {Sang Eun} and Kim, {Min Seok} and Kim, {Jae Joong} and Hwang, {Kyung Kuk} and Chae, {Shung Chull} and Baek, {Sang Hong} and Kang, {Seok Min} and Choi, {Dong Ju} and Yoo, {Byung Su} and Youngkeun Ahn and Park, {Hyun Young} and Cho, {Myeong Chan} and Oh, {Byung Hee}",

note = "Funding Information: The KorAHF registry was supported by Research of Korea Centers for Disease Control and Prevention [2010-E63003-00, 2011-E63002-00, 2012-E63005-00, 2013-E63003-00, 2013-E63003-01, 2013-E63003-02, 2016-ER6303-00, 2016-ER6303-01]. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The KorAHF registry was supported by Research of Korea Centers for Disease Control and Prevention [2010-E63003-00, 2011-E63002-00, 2012-E63005-00, 2013-E63003-00, 2013-E63003-01, 2013-E63003-02, 2016-ER6303-00, 2016-ER6303-01]. Publisher Copyright: {\textcopyright} 2018 Cho et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2018",

month = dec,

doi = "10.1371/journal.pone.0209088",

language = "English",

volume = "13",

journal = "PloS one",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "12",

}

TY - JOUR

T1 - Nutritional risk index as a predictor of mortality in acutely decompensated heart failure

AU - Cho, Jae Yeong

AU - Kim, Kye Hun

AU - Cho, Hyun Jai

AU - Lee, Hae Young

AU - Choi, Jin Oh

AU - Jeon, Eun Seok

AU - Lee, Sang Eun

AU - Kim, Min Seok

AU - Kim, Jae Joong

AU - Hwang, Kyung Kuk

AU - Chae, Shung Chull

AU - Baek, Sang Hong

AU - Kang, Seok Min

AU - Choi, Dong Ju

AU - Yoo, Byung Su

AU - Ahn, Youngkeun

AU - Park, Hyun Young

AU - Cho, Myeong Chan

AU - Oh, Byung Hee

N1 - Funding Information: The KorAHF registry was supported by Research of Korea Centers for Disease Control and Prevention [2010-E63003-00, 2011-E63002-00, 2012-E63005-00, 2013-E63003-00, 2013-E63003-01, 2013-E63003-02, 2016-ER6303-00, 2016-ER6303-01]. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The KorAHF registry was supported by Research of Korea Centers for Disease Control and Prevention [2010-E63003-00, 2011-E63002-00, 2012-E63005-00, 2013-E63003-00, 2013-E63003-01, 2013-E63003-02, 2016-ER6303-00, 2016-ER6303-01]. Publisher Copyright: © 2018 Cho et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2018/12

Y1 - 2018/12

N2 - 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.

AB - 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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JO - PloS one

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

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