# Analysis of the value of nutritional status indexes (ALB, Hb, GNRI) in prognostic assessment of elderly patients with chronic heart failure

## TL;DR

This study shows that low levels of albumin, hemoglobin, and GNRI are linked to worse outcomes in elderly patients with chronic heart failure.

## Contribution

The study demonstrates the strong prognostic value of nutritional indexes in elderly chronic heart failure patients.

## Key findings

- Low ALB, Hb, and GNRI levels were significantly associated with poor prognosis in elderly CHF patients.
- ALB, Hb, and GNRI showed high predictive accuracy with AUCs of 0.845, 0.884, and 0.896, respectively.
- Nutritional indexes were identified as independent prognostic factors alongside cardiac and inflammatory markers.

## Abstract

This study evaluated the prognostic value of nutritional status indexes [albumin (ALB), hemoglobin (Hb), Geriatric Nutritional Risk Index (GNRI)] in elderly chronic heart failure (CHF) patients.

A total of 190 elderly CHF patients were categorized into good (n = 142) and poor (n = 48) prognosis groups based on 1-year outcomes (rehospitalization or all-cause death). Clinical data, including cardiac function [New York Heart Association (NYHA) class], inflammatory markers, and nutritional indexes (ALB, Hb, GNRI), were analyzed. Spearman correlation was used to assess the relationship between nutritional markers and NYHA class. Patients were stratified by median ALB, Hb, and GNRI levels to compare poor prognosis incidence. Kaplan–Meier survival and Cox regression analyses identified prognostic factors, while Receiver Operating Characteristic (ROC) curves evaluated predictive performance.

The poor prognosis group exhibited significantly lower ALB, Hb, and GNRI levels (P < 0.001). These markers declined with worsening NYHA class (P < 0.001) and correlated negatively with cardiac function. Low ALB, Hb, and GNRI groups had higher poor prognosis rates (P < 0.001), confirmed by Kaplan–Meier analysis. Cox regression identified left ventricular ejection fraction (LVEF), N-terminal pro-B-type natriuretic peptide (NT-proBNP), NYHA class, ALB, Hb, and GNRI as independent prognostic factors. ROC analysis showed ALB [area under the curve (AUC) = 0.845], Hb (AUC = 0.884), and GNRI (AUC = 0.896) as strong predictors with high sensitivity/specificity.

Reduced ALB, Hb, and GNRI levels are associated with poor CHF prognosis in elderly patients. These nutritional indexes offer reliable predictive value for clinical prognosis assessment.