Author + information
- Diego Lopez Otero1,
- Pablo José Antúnez Muiños2,
- Diego Iglesias Alvarez3,
- Ramiro Trillo Nouche4 and
- José Ramón González Juanatey2
To determine the prevalence of malnutrition, as assessed through the nutritional risk index (NRI), in patients undergoing transcatheter aortic valve implantation (TAVI) and the prognostic impact of this status.
322 patients undergoing TAVI were included in a retrospective study between November 2008 and October 2016. The NRI was calculated as 1.519 x albumin (g/L) + 41.7 x (real weight [kg]/ideal weight [kg]). The relationship between NRI and mortality during the follow-up was analyzed using multivariable logistic regression models.
The mean age of the population was 82 ± 6 years, 56% women and with a logistic EuroScore of 18.39 ± 10.9%. The mean NRI was 98.1 ± 7.0% and the prevalence of moderate-severe malnutrition, defined as an NRI <97.5%, was 42.7% (n=137). The remaining patients did not present malnutrition or in a mild degree (NRI ≥ 97.5%). During the follow-up period (709 ± 492 days), more patients died in the moderate-severe malnutrition group than in the non-malnutrition-mild group (21.09%, n = 27, vs 11.62%, n = 20, p = 0.036). In the multivariate analysis (age, logistic EuroScore and renal function, estimated by MDRD4, were included), NRI was independently associated with mortality after TAVI implantation, with HR = 2.4, 95% CI 1.2- 5.1; p = 0.014. Kaplan-Meier survival curves for the two groups are shown in Figure 1.
Malnutrition is a frequent comorbidity among patients undergoing TAVI. NRI in the moderate-severe degree is independently associated with an increased risk of death during long-term follow-up in these patients.
STRUCTURAL: Valvular Disease: Aortic