Abstract
Background: The Geriatric Nutritional Risk Index (GNRI), based on serum albumin levels and body index, is a simple nutrition-related risk assessment instrument.
Objective: We aimed to evaluate the prognostic value of GNRI in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention.
Methods: We retrospectively analyzed in-hospital and long-term adverse outcomes of 786 patients with STEMI. Patients were divided into 2 groups based on their GNRI score (<=98 vs >98). Kaplan-Meier curves and Cox regression models were used to evaluate the prognostic value of the GNRI score in patients with STEMI.
Results: Of the patients enrolled, 78 (9.9%) died of cardiovascular disease during the median follow-up period of 12.4 (8.3-15.5) months. Patients with a GNRI score of 98 or lower had a higher incidence of bleeding, cardiogenic shock, infection, acute respiratory failure, malignant dysrhythmia, atrial fibrillation, and in-hospital mortality as well as a longer length of hospital stay (P < .05). Kaplan-Meier survival analysis showed that patients with a lower GNRI score had lower cumulative survival (P < .001), regardless of age group (elderly vs middle-aged) or sex. Multivariable Cox regression analysis showed that the adjusted hazard ratio of the GNRI score for cardiovascular death was 0.934 (95% confidence interval, 0.896-0.974; P = .001).
Conclusion: The GNRI can be used to assess prognosis of patients with STEMI and to identify those who may benefit from further nutritional assessment and intervention.