Geriatric nutritional risk index associated to long-term prognosis and length of hospitalization in the contemporary transcatheter aortic valve replacement era.

backgroundMalnutrition is a common comorbidity in elderly patients with severe aortic valve stenosis undergoing transcatheter aortic valve replacement (TAVR). The geriatric nutritional risk index (GNRI), a validated and easy-to-use tool, has been previously associated with short/mid-term outcomes in such patients. This study aimed to confirm this association in the long-term in the contemporary TAVR era using new-generation devices and to evaluate its impact on length of hospitalization.

methodsA total of 1090 consecutive patients aged ≥ 65 years undergoing TAVR between October 2015 and December 2021 at a single tertiary center were included. Patients were stratified into two groups based on baseline GNRI: the GNRI > 98 (low-risk) group and the GNRI ≤ 98 (moderate-to-high risk) group. The primary endpoint was all-cause mortality. Secondary endpoints included total length of hospitalization and length of intensive care unit stay. Kaplan-Meier curves and Cox regression models were used to assess survival differences and potential independent predictors.

resultsPatients with GNRI ≤ 98 had significantly higher cumulative mortality rates at all evaluated time points compared to patients with GNRI > 98 (30-day: 6.9%

conclusionsIn this large European cohort, GNRI was confirmed to be an independent predictor for long-term mortality up to five years in the contemporary era of TAVR use with new-generation devices. Hospital stay was longer in patients with lower GNRI. This easy-to-use index could play a valuable role in the preprocedural assessment of patients undergoing TAVR and studies to explore the use of nutritional preprocedural optimization of patients with low GNRI values are warranted.