Prognostic influence of objective nutritional indexes on mortality after surgical aortic valve replacement in elderly patients with severe aortic stenosis (from the nutrition‐SAVR trial). Issue 6 (14th February 2021)

• Record Type: Journal Article
• Authors: Gürbak, İsmail; Güner, Ahmet; Güler, Arda; Şahin, Ahmet A.; Çelik, Ömer; Uzun, Fatih; Onan, Burak; Ertürk, Mehmet
• Is Part Of: Journal of cardiac surgery. Volume 36:Issue 6(2021)
• Page Start: 1872
• Page End: 1881
• Publication Date: 2021-02-14
• Subjects: fragility -- nutritional index -- severe aortic stenosis -- surgical aortic valve replacement; Heart -- Surgery -- Periodicals; 617.412005
• DOI: 10.1111/jocs.15434
• Languages: English
• ISSNs: 0886-0440

Abstract

Abstract: Aim: Several scoring systems, such as controlling nutritional status (CONUT) score, geriatric nutritional risk index (GNRI), and prognostic nutritional index (PNI), have been previously described to show nutritional status. In the present study, we aimed to investigate the value of these scoring systems in predicting in‐hospital and long‐term mortality in patients undergoing surgical aortic valve replacement (SAVR). Methods: PNI, GNRI, and CONUT were determined using the receiver operator characteristics curve analysis in 150 consecutive elderly patients (age: 70 (66–74) years, male: 78) who underwent SAVR due to degenerative severe aortic stenosis (AS). Patients were divided into two groups according to cutoff values from these indexes. Results: During the 50 ± 31 months follow‐up period, a total of 36 (24%) patients died. 30‐day mortality, 1‐year mortality, and total mortality were significantly higher in lower PNI, lower GNRI, and higher CONUT groups. PNI cutoff value was 49.2, GNRI cutoff value was 102.5, and CONUT cutoff value was 1.5. PNI ≤ 49.2, GNRI ≤ 102.5, and CONUT > 1.5 values were found to be independent predictors of total mortality even after risk adjustment. In addition, in the mortality group, PNI (53.7 ± 5.9 vs. 47.4 ± 6.3; p < .001) and GNRI (108 ± 10 vs. 99 ± 6.3); p < .001) were significantly lower, while CONUT score (1 [0–2] vs. 2 [0.2–3]; p < .001) was significantly higher. Conclusion: Objective nutritional indexes including CONUT score, PNI, and GNRI are important prognostic factors and those indexes should be part of frailty assessment in patients with severe AS.