PNI Shows Promise as a Prognostic Tool for Elderly AF Patients
Uncertainty Surrounding the Predictive Value of Nutritional Assessment in Elderly AF Patients
Several objective and comprehensive nutritional assessment methods have been used for predicting adverse outcomes in elderly patients with various diseases. However, their effectiveness in forecasting long-term outcomes for elderly individuals afflicted with atrial fibrillation (AF), remains unclear.
This study sought to determine the prognostic value of four nutritional indices – the Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI), Controlling Nutritional Status (CONUT), and High-Sensitivity Modified Glasgow Prognostic Score (HS-mGPS) – in forecasting the long-term prognosis of elderly patients with AF.
Study Design and Patient Population
This retrospective study, conducted at a single center, involved 261 elderly patients diagnosed with AF between December 2015 and December 2021. Patients were categorized into two groups: all-cause death and survival, based on follow-up data.
Analyzing the Link between Nutritional Status and Mortality
Researchers utilized Kaplan–Meier analysis and COX regression to investigate the relationship between all-cause mortality and nutritional scores derived from the various indices. Additionally, Receiver Operating Characteristic (ROC) curves were employed to compare the predictive capability of the four nutritional screening tools for the defined endpoint.
PNI Emerges as a Potential Prognostic Indicator
During the follow-up period, 119 cases (45.59%) resulted in all-cause mortality. A significant relationship was observed between higher cumulative incidence of all-cause death and lower PNI and GNRI scores, as well as higher CONUT and HS-mGPS levels.
Specifically,
Low PNI (HR 1.325, 95% CI 1.032-2.857, P=0.025)
and high HS-mGPS (HR 2.166, 95% CI 1.281– 4.326, P=0.023)
were independently and significantly associated with an increased risk of all-cause death, as determined by multivariate COX regression analysis.
Notably, the PNI demonstrated the best area under the curve value (AUC: 0.696, 95% CI 0.632-0.760), suggesting superior predictive power among the four indices.
Conclusion: A Simple Tool for Predicting Long-Term Outcomes
Our findings suggest that among the four nutritional risk screening tools evaluated, PNI might serve as a straightforward and valuable indicator for predicting the long-term prognosis of elderly patients with AF. This finding warrants further investigation and validation in larger, prospective studies.
What is the Prognostic Nutritional Index (PNI) and how is it determined?
## PNI: A Potential Crystal Ball for Elderly AF Patients?
**Good evening and welcome back to HealthLine.** Tonight, we’re discussing a new study that explores the potential of a simple nutritional assessment tool to predict long-term outcomes in elderly patients with atrial fibrillation, or AF. Joining us is Dr. [Guest Name], a leading cardiologist with expertise in geriatric care. Welcome, Dr. [Guest Name].
**Dr. [Guest Name]:** Thank you for having me.
**Host:** Dr. [Guest Name], this study looked at four different nutritional indices. Can you tell us a bit more about them?
**Dr. [Guest Name]:** Certainly. These indices, including the Prognostic Nutritional Index (PNI), essentially assess a patient’s nutritional status and immune system health. They use factors like albumin levels, total lymphocyte count, and other clinical data to get a picture of the patient’s overall health. .[[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10574320/)
**Host:** So, what did the study find regarding the effectiveness of these indices in predicting outcomes for elderly AF patients?
**Dr. [Guest Name]:** The study found that the PNI showed particular promise. [[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10574320/) It suggests that PNI could be a valuable tool for identifying elderly AF patients who may be at a higher risk for adverse outcomes.
**Host:** This is fascinating. What are the implications of these findings for clinical practice?
**Dr. [Guest Name]:** Well, it means that incorporating a simple PNI assessment could help us identify patients who might benefit from more intensive monitoring or interventions to improve their nutritional status and potentially reduce their risk of complications.
**Host:** That’s incredibly hopeful news. Thank you so much for sharing your insights with us, Dr. [Guest Name].
**Dr. [Guest Name]:** It was my pleasure.
