Nomogram model based on scores of geriatric nutritional risk index and neutrophil/lymphocyte ratio for predicting prognosis in patients with chronic heart failure

Zhong Shan; Wang Qinhang; Li Zhihao; Zhang Jiejian; Zhou Birong

doi:10.3969/j.issn.1674-4055.2024.08.09

Abstract：Objective To predict the risk of cardiovascular composite endpoint events in patients with chronic heart failure(CHF)through establishing nomogram model based on scores of geriatric nutritional risk index(GNRI),neutrophil/lymphocyte ratio(NLR)and multi-factor Cox regression analysis.Methods The clinical materials were retrospectively analyzed in CHF patients(n=418)chosen from Department of Cardiology in the First Affiliated Hospital of Anhui Medical Universityfrom Jan.2021 to Oct.2022.The patients were divided,according to occurrence of cardiovascular composite endpoint events(all-cause death or re-admission due to heart failure relapse or exacerbation),into endpoint event group(n=233)and non-endpoint event group(n=185).The risk factors for cardiovascular composite endpoint events were screened by using Cox regression analysis.A nomogram was established by using screened independent predictive factors for predicting risk of cardiovascular composite endpoint events occurrence in CHF patients.Results The results of multi-factor Cox regression analysis showed that age(HR=1.021,95％CI:1.007-1.036),NLR(HR=1.092,95％CI:1.053-1.133),LVEF(HR=0.965,95％CI:0.947-0.984),BMI(HR=1.059,95％CI:1.019-1.101),GNRI scores(HR=2.611,95％CI:1.865-3.656),AF(HR=1.459,95％CI:1.097-1.939),diabetes(HR=1.886,95％CI:1.354-2.626)were independent risk factors of composite endpoint events(P＜0.05),and SGLT-2i(HR=0.476,95％CI:0.337-0.627)was an independent protective factor(P＜0.001)of composite endpoint events.A nomogram was established by using above risk factors of prognosis and analysis results showed its predictive ability was good.The calibration curve of nomogram showed that the model had a higher consistency in predicting risk of cardiovascular composite endpoint events in CHF patients.Conclusion The nomogram model established based on GNRI scores and NLR combined with traditional risk factors according to multi-factor Cox regression analysis has a higher performance in predicting prognosis in CHF patients.The nomogram model is able to screen the causative factors and risk factors that may lead to recurrence and aggravation of heart failure at an early stage,which can provide a reference basis for clinical treatment and improve prognosis in CHF patients to a certain extent.