Predictive factor among clinical parameters on admission in the patients hospitalized with worsening heart failure.

Abstract

【Aim】We investigated the predictive factor among clinical parameters on admission in the patients hospitalized with worsening heart failure.
【Patients and Methods】The subjects were 147 patients worsening heart failure who had been admitted from December 2011 to December 2012 to Saiseikai Matsusaka General Hospital. We categorized them into two groups, survival group and death group. We studied the relationship among age, physical measurement and blood biochemical examination on admission and outcome in heart failure patients.
【Results】In-hospital mortality rate in our subjects was 13.6% (20 of 147). In the clinical parameters, multivariate analysis revealed that Onodera's prognostic nutritional index(PNI) value was most reliable predictive factor for mortality of heart failure patients. Also estimated glomerular filtration rate(eGFR) value was found to be related with death. We tried to determine those cut off values of PNI and eGFR value by receiver-operating characteristic curve. The former was 40, and the latter was 36. Kaplan-Meier analysis showed that eGFR value was more powerful predictor than PNI value at long-term prognosis.
【Conclusion】We concluded that PNI value was the most powerful predictive factor for in-hospital mortality, and eGFR was more powerful predictor at long-term prognosis among clinical parameters in heart failure patients.Therefore, the early intervention though nutrition therapy may improve the outcome in heart failure patients to PNI value <40.