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Decreased Nutritional Risk Index is associated with mortality after heart transplantation
Author(s) -
Krishnan Aravind,
Bigelow Benjamin,
Hsu Steven,
Gilotra Nisha A.,
Sharma Kavita,
Choi Chun Woo,
Kilic Ahmet
Publication year - 2021
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.14253
Subject(s) - medicine , malnutrition , dialysis , transplantation , heart transplantation , proportional hazards model , multivariate analysis , surgery
Validated scoring tools, such as the Nutritional Risk Index (NRI), can aid clinicians in quantifying the degree of malnourishment in patients prior to an operation. We evaluated the association between NRI and outcomes after heart transplantation. Methods The United Network for Organ Sharing (UNOS) database was used to identify adult patients (age > 18) undergoing heart transplantation between 1987 and 2016. NRI was calculated and categorized into previously established groupings representing severity of malnutrition. Multivariate Cox proportional hazards modeling were used to assess the primary outcome of all‐cause mortality. Results A total of 25,236 patients were included in the analysis. Most patients (75.4%) were male. Malnourishment was absent (NRI ≥ 100) in 11,022 (44%) patients, while 2,898 (12%) were mildly malnourished (97.5 ≤ NRI < 100), 8,685 (34%) were moderately malnourished (83.5 ≤ NRI < 97.5), and 2,631 (10%) were severely malnourished (NRI < 83.5). Moderate‐to‐severe malnutrition was associated with increased mortality (HR = 1.18, p < .001, 95%CI: 1.13‐1.24), and post‐transplant renal failure requiring dialysis (OR: 1.13, p < .001, 95%CI: 1.03‐1.23). Conclusion Malnourishment determined by NRI is independently associated with mortality and post‐transplant dialysis after heart transplant. This is the largest study of NRI in heart transplant recipients.