基于老年营养风险指数构建老年射血分数保留型心力衰竭患者的预后模型

doi:10.20047/j.issn1673-7210.2022.29.06

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Abstract Objective To explore the value of geriatric nutritional risk index (GNRI) in evaluating the prognosis of elderly patients with heart failure with preserved ejection fraction (HFpEF), and to establish a nomogram model to predict the prognosis of elderly patients with HFpEF. Methods A total of 135 patients diagnosed with HFpEF in the First Affiliated Hospital of Soochow University from January 2018 to January 2020 were retrospectively included. The patients were divided into case group (44 cases) and control group (91 cases) according to whether major adverse cardiovascular events (MACE) occurred within a year. The clinical data of patients were collected, GNRI was calculated, and multivariate logistic regression was used to analyze the risk factors of poor prognosis in elderly patients with HFpEF. R software was used to construct a nomogram model to predict the occurrence of MACE in patients within a year. Results The age, the ratio of NYHA grade ≥ Ⅲ, the proportion of diabetes, creatinine, high-sensitivity troponin T, N-terminal brain natriuretic peptide precursor, and pulmonary artery pressure of the case group were higher than those of the control group, and the differences were statistically significant (P ＜ 0.05); while the hemoglobin, albumin and GNRI were lower than those in the control group, and the differences were statistically significant (P ＜ 0.05). Multivariate logistic regression analysis showed that the ratio of NYHA grade ≥ Ⅲ at admission (OR = 4.213, 95%CI: 1.476 to 12.022) and diabetes (OR = 3.282, 95%CI: 1.198 to 8.990) were the risk factors for the occurrence of MACE within a year in elderly patients with HFpEF (OR > 1, P ＜ 0.05); while higher GNRI (OR = 0.919, 95%CI: 0.853 to 0.990) was a protective factor for the occurrence of MACE in elderly patients with HFpEF within a year (OR < 1, P ＜ 0.05). The area under the ROC curve of the Nomogram model constructed based on GNRI was 0.816 (95%CI: 0.734 to 0.897, P ＜ 0.01). Conclusion NYHA grade ≥ Ⅲ at admission and diabetes mellitus are independent risk factors for MACE within a year in elderly patients with HFpEF, and higher GNRI is a protective factor. The nomogram model constructed in this study has a good predictive value for the prognosis of elderly HfpEF patients within a year.

Key words： Heart failure with preserved ejection fraction Geriatric nutritional risk index Prognosis Risk factors Prognostic model

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	ZHANG Mingyang WANG Zuoxiang GU Yiyu JIANG Tingbo

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ZHANG Mingyang WANG Zuoxiang GU Yiyu JIANG Tingbo. Construction of a prognostic model for elderly patients with heart failure with preserved ejection fraction based on geriatric nutritional risk index[J]. 中国医药导报, 2022, 19(29): 29-33.

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https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2022.29.06 OR https://www.yiyaodaobao.com.cn/EN/Y2022/V19/I29/29

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