Prognostic impact of malnutrition assessed using geriatric nutritional risk index in patients aged >80 years with heart failure

Aims: Malnutrition in elderly patients is one of the important issues in an aging society. We aimed to investigate the prevalence and prognostic impact of malnutrition assessed using the geriatric nutritional risk index in very elderly patients hospitalized owing to heart failure. Methods: We enrolled 213 consecutive patients aged > 80 years who were hospitalized with heart failure. The mean age was 87.2 +/- 4.9 years, and 43.7% of them were male. The nutritional status on admission was evaluated using the geriatric nutritional risk index, which was calculated as follows: 14.89 x serum albumin (g/dL) + 41.7 x body mass index/22. The patients were divided into two groups, a low geriatric nutritional risk index group (<92) with malnutrition risk and a high geriatric nutritional risk index group (> 92) without malnutrition risk. Results: The mean geriatric nutritional risk index of all patients was 90.7 +/- 10.6, and 108 patients (50.7%) had low geriatric nutritional risk index. During the 540-day follow-up, the all-cause mortality was significantly higher in the low geriatric nutritional risk index group than in the high geriatric nutritional risk index group (35.7% vs. 12.9%, p < 0.001). The Cox proportional-hazards regression analysis revealed that low geriatric nutritional risk index was an independent predictor of mortality (hazard ratio, 2.28; 95% confidence interval, 1.15-4.49; p = 0.02). Conclusions: Low geriatric nutritional risk index on admission was common and was associated with poor prognosis in patients aged > 80 years who were hospitalized owing to heart failure.