Analysis of the predictive value of four nutritional assessment tools for mortality risk in elderly patients with chronic heart failure
Li Tingru
Zheng Wei
Lu Miao
Tang Yifan
Sun Guozhen
Abstract：Objective To compare the predictive value of four nutritional assessment tools for all-cause mortality in elderly patients with chronic heart failure(CHF).Methods A prospective study was conducted on 203 elderly CHF patients admitted to Nanjing Medical University First Affiliated Hospital between January 1,2017,and June 30,2018.Nutritional status was assessed by the Mini Nutritional Assessment-Short Form(MNA-SF),Geriatric Nutritional Risk Index(GNRI),Controlling Nutritional Status(CONUT)score,and Prognostic Nutritional Index(PNI).Patients were followed for all-cause mortality after discharge.Receiver operating characteristic(ROC)curves were plotted to calculate areas under the curve(AUC).Kaplan Meier survival analysis and Cox proportional hazards regression model analysis were performed sequentially.Results The median follow-up time was 1107 days,during which 104 patients died and 99 survived.The AUCs for MNA-SF score,GNRI score,CONUT score,and PNI score are 0.771,0.691,0.691,and 0.651,respectively.Kaplan Meier curves showed that poorer nutritional status was associated with lower survival(log rank P＜0.01 for all tools).In multivariate Cox analysis,MNA-SF score(RR=0.74,95%CI:0.67～0.81),CONUT score(RR=1.21,95%CI:1.09～1.35),GNRI score(RR=0.92,95%CI:0.92～0.98),PNI score(RR=0.92,95%CI:0.88～0.96)were independent risk factors for mortality(P＜0.01).Comparing various assessment tool groups,the MNA-SF malnutrition risk group had a 1.71-foldhigher risk of death 95%CI:1.03～2.82,(P＜0.05)and the malnutrition group a 6.00-fold higher risk 95%CI:3.29～10.94,(P＜0.01).The high-risk CONUT group had a 4.39-fold higher risk 95%CI:1.33～14.47,(P=0.01),and the severe-risk GNRI group had a 6.78-fold higher risk 95%CI:2.94～15.67,(P＜0.01).Conclusion Nutritional status is an independent risk factor in elderly CHF patients:the poorer the nutrition,the higher the mortality risk.The MNA-SF demonstrates superior predictive value for mortality risk compared with GNRI,CONUT,and PNI.
Keywords：Chronic heart failureNutritional statusPrognosisSurvival analysis
Publication Date：2025-09-20
Online Publishing Date：2025-11-04(First online date of this platform, not the publication date of the document)
Pages：7( 1095-1101 )