Prognostic value of elderly nutritional risk index combined with serum NT-proBNP levels in elderly pa-tients with chronic heart failure combined with community-acquired pneumonia

Feng Liaoliao; Yan Zhumei; Li Xiaxia

doi:10.3969/j.issn.1674-4055.2024.11.10

Abstract：Objective To investigate the prognostic value of the geriatric nutritional risk index(GNRI)combined with serum N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels in elderly patients with chronic heart failure(CHF)combined with community-acquired pneumonia(CAP).Methods 161 elderly patients with CHF combined with CAP admitted to the Department of infectious diseases of Yulin Traditional Chinese Medicine Hospital from January 2021 to May 2023(CHF combined with CAP group)were selected,and another 87 elderly patients with CHF alone during the same period(CHF group)were selected,and were classified into the group with poor prognosis(95 cases)and the group with good prognosis(66 cases)according to whether or not they suffered from a major adverse cardiovascular event at a follow-up period of 3 months.GNRI was calculated and serum NT-proBNP levels were measured by chemiluminescence immunoassay.Multifactorial logistic regression was used to analyze the factors of poor prognosis in elderly patients with CHF combined with CAP,and a receiver operating characteristic curve was used to analyze the value of GNRI combined with serum NT-proBNP levels in assessing poor prognosis in elderly patients with CHF combined with CAP.Results Compared with the CHF group,the CHF combined with CAP group had lower GNRI and higher serum NT-proBNP levels(P＜0.05).At 3-month follow-up,the incidence of poor prognosis in 161 elderly patients with CHF combined with CAP was 59.01％.Compared with the group with good prognosis,the group with poor prognosis had lower GNRI and higher serum NT-proBNP levels(P＜0.05).New York Heart Association cardiac function class Ⅳ,mechanical ventilation,reduced GNRI,and elevated NT-proBNP were independent risk factors for poor prognosis in elderly patients with CHF combined with CAP,and elevated oxygenation index and LVEF were independent protective factors(P＜0.05).The area under the curve for GNRI combined with serum NT-proBNP levels to assess poor prognosis in elderly patients with CHF combined with CAP was 0.867,which was greater than 0.788 and 0.776 for GNRI and serum NT-proBNP levels assessed individually(P＜0.05).Conclusions Reduced GNRI and increased serum NT-proBNP levels in elderly patients with CHF combined with CAP are strongly associated with poor prognosis,and the use of GNRI combined with serum NT-proBNP levels to assess the prognosis of elderly patients with CHF combined with CAP has a high predictive value.