Survival and Nutritional Status of Male and Female Heart Transplant Patients Based on the Nutritional Risk Index

Nutrients. 2020 Dec 17;12(12):3868. doi: 10.3390/nu12123868.

Abstract

Malnutrition among heart-transplant patients may affect survival. The aim was to investigate the survival and nutrition status among male and female heart transplant patients who underwent transplantation, before and 1 year after surgery based on the nutritional risk index (NRI). The medical records of ninety heart-transplant patients (2009-2014) from the King Faisal Specialist Hospital, Riyadh, were reviewed. The assessment included demographic data, anthropometric measurements, and NRI calculation. Moreover, postoperative data included the length of stay and survival. Paired t-test and survival analysis by Kaplan-Meier (KM) curves were used. A total of 90 patients (males 77.78%) were included. The prevalence of malnutrition in the preoperative phase by NRI was 60% (7.78% as severe; 40% as moderate, and 12.22% mild NRI scores). After 1 year, body mass index (BMI) and NRI increased significantly (p < 0.001). Furthermore, NRI was significantly different between men and women (p < 0.01), while KM survival curves were insignificantly different (p = 0.67). Recipients with postoperative moderate or severe nutritional risk (NRI < 97.5) had significantly shorter survival in the first-year post-transplantation (HR = 0.82; 95% CI, 0.75-0.89; p < 0.001). Our findings indicate that the NRI after 1 year of transplant correlated significantly with mortality. Besides, there was no significant gender difference regarding survival; however, malnutrition and low survival were more prominent among women.

Keywords: gender difference; heart transplant; malnutrition; nutritional risk index; survival.

MeSH terms

  • Adult
  • Cohort Studies
  • Female
  • Heart Transplantation / methods
  • Heart Transplantation / statistics & numerical data*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Malnutrition / epidemiology*
  • Nutrition Assessment*
  • Nutritional Status*
  • Prevalence
  • Retrospective Studies
  • Risk Assessment
  • Saudi Arabia / epidemiology
  • Severity of Illness Index
  • Sex Factors
  • Survival Rate