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Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2017;70:639-45 - Vol. 70 Num.08 DOI: 10.1016/j.rec.2017.01.005

Prognostic Value of the Nutritional Risk Index in Heart Transplant Recipients

Eduardo Barge-Caballero a,b,, Fernando García-López a,b, Raquel Marzoa-Rivas a,b, Gonzalo Barge-Caballero a,b, David Couto-Mallón a,b, María J. Paniagua-Martín a,b, Miguel Solla-Buceta b,c, Carlos Velasco-Sierra b,d, Francisco Pita-Gutiérrez b,e, José M. Herrera-Noreña b,d, José J. Cuenca-Castillo b,d, José Manuel Vázquez-Rodríguez a,b, María G. Crespo-Leiro a,b

a Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
b Instituto de Investigación Biomédica, A Coruña, Spain
c Servicio de Medicina Intensiva, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
d Servicio de Cirugía Cardiaca, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
e Servicio de Endocrinología y Nutrición, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain

Refers to

Nutritional Status in Advanced Heart Failure and Heart Transplant Patients
Amelia Carro, Josefa María Panisello, Andrew J. Stewart Coats
Rev Esp Cardiol. 2017;70:626-8
Full text - PDF

Keywords

Nutritional risk index. Heart transplant. Malnourishment. Outcomes.

Abstract

Introduction and objectives

To study the prognostic impact of preoperative nutritional status, as assessed through the nutritional risk index (NRI), on postoperative outcomes after heart transplantation (HT).

Methods

We conducted a retrospective, single-center study of 574 patients who underwent HT from 1991 to 2014. Preoperative NRI was calculated as 1.519 × serum albumin (g/L) + 41.7 × (body weight [kg] / ideal body weight [kg]). The association between preoperative NRI and postoperative outcomes was analyzed by means of multivariable logistic regression and multivariable Cox regression.

Results

Mean NRI before HT was 100.9 ± 9.9. According to this parameter, the prevalence of severe nutritional risk (NRI < 83.5), moderate nutritional risk (83.5 ≤ NRI < 97.5), and mild nutritional risk (97.5 ≤ NRI < 100) was 5%, 22%, and 10%, respectively. One year post-transplant mortality rates in these 4 categories were 18.2%, 25.3%, 7.9% and 10.2% (P < .001), respectively. The NRI was independently associated with a lower risk of postoperative infection (adjusted OR, 0.97; 95%CI, 0.95-1.00; P = .027) and prolonged postoperative ventilator support (adjusted OR, 0.96; 95%CI, 0.94-0.98; P = .001). Patients at moderate or severe nutritional risk had significantly higher 1-year post-HT mortality (adjusted HR, 1.55; 95%CI, 1.22-1.97; P < .001).

Conclusions

Malnourished patients have a higher risk of postoperative complications and mortality after HT. Preoperative NRI determination may help to identify HT candidates who might benefit from nutritional intervention.

1885-5857/© 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved