What Is the Additive Value of Nutritional Deficiency to Va-Fi in the Risk Assessment For Heart Failure Patients?

Authors

Seulgi Erica Kim
Mehrnaz Azarian
Aanand D Naik
Catherine Park
Molly J Horstman
Salim S Virani
Orna Intrator
Christopher I Amos
Ariela Orkaby
Javad Razjouyan

Publication Date

4-30-2024

Journal

The Journal of Nutrition, Health and Aging

Abstract

OBJECTIVES: to assess the impact of adding the Prognostic Nutritional Index (PNI) to the U.S. Veterans Health Administration frailty index (VA-FI) for the prediction of time-to-death and other clinical outcomes in Veterans hospitalized with Heart Failure.

METHODS: A retrospective cohort study of veterans hospitalized for heart failure (HF) from October 2015 to October 2018. Veterans ≥50 years with albumin and lymphocyte counts, needed to calculate the PNI, in the year prior to hospitalization were included. We defined malnutrition as PNI ≤43.6, based on the Youden index. VA-FI was calculated from the year prior to the hospitalization and identified three groups: robust (≤0.1), prefrail (0.1-0.2), and frail (>0.2). Malnutrition was added to the VA-FI (VA-FI-Nutrition) as a 32

RESULTS: We identified 37,601 Veterans hospitalized for HF (mean age: 73.4 ± 10.3 years, BMI: 31.3 ± 7.4 kg/m

CONCLUSION: Adding PNI to VA-FI provides a more accurate and comprehensive assessment among Veterans hospitalized for HF. Clinicians should consider adding a specific nutrition algorithm to automated frailty tools to improve the validity of risk prediction in patients hospitalized with HF.

Keywords

All-cause mortality, Frailty index, Heart failure, Malnutrition