Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(7), 745–756. https://doi.org/10.1002/clc.24029 Wanli Chen et al.
Points
- A retrospective cohort study using the MIMIC-III database examined the interplay between the lactate/albumin (L/A) ratio and geriatric nutritional risk index (GNRI) on mortality in critically ill elderly heart failure (HF) patients.
- Among 5627 patients, elevated L/A ratios or GNRI values ≤58 were associated with significantly increased 28-day and 1-year all-cause mortality risks (p < .01).
- The study uncovered a substantial multiplicative interaction effect between the L/A ratio and GNRI score, with statistical significance for 28-day and 1-year all-cause mortality (p < .05).
- Specifically, higher L/A ratios were linked to elevated mortality risks among patients with GNRI scores ≤58 than those with GNRI scores >58.
- The findings underscore the importance of nutrition-focused interventions in managing critically ill elderly HF patients, mainly when dealing with elevated L/A ratios, emphasizing the need for holistic patient care strategies.
Summary
In a retrospective cohort study utilizing the Medical Information Mart for Intensive Care III (MIMIC-III) database, the authors aimed to explore the potential multiplicative interaction between two key variables: the lactate/albumin (L/A) ratio and the geriatric nutritional risk index (GNRI) among critically ill elderly patients with heart failure (HF). The study encompassed a substantial cohort of 5627 patients, and its primary outcomes of interest were the 28-day and 1-year all-cause mortality rates. The primary independent variables under investigation were the L/A ratio and GNRI. Intriguingly, the data revealed that patients with elevated L/A ratios or GNRI values of ≤58 faced a significantly higher risk of experiencing both 28-day and 1-year all-cause mortality (p < .01).
One of the most compelling findings was the discovery of a substantial multiplicative interaction effect between the L/A ratio and GNRI score, with statistical significance observed for both 28-day and 1-year all-cause mortality (both p < .05). Specifically, the research demonstrated that an elevated L/A ratio was linked to an elevated risk of 28-day and 1-year all-cause mortality among patients with a GNRI score of ≤58, as opposed to those with a GNRI score exceeding 58. These results underscore the critical importance of nutrition-focused interventions in managing critically ill elderly HF patients with elevated L/A ratios, particularly those with lower GNRI scores.
This comprehensive investigation provides valuable insights into the intricate interplay between the L/A ratio and GNRI score, illuminating their combined influence on mortality outcomes among critically ill elderly HF patients. The study underscores the significance of tailoring therapeutic strategies to address nutritional status and L/A ratio in this vulnerable patient population, emphasizing the potential benefits of a holistic approach to patient care. These findings call for further research and the development of targeted interventions to improve the prognosis and outcomes of elderly HF patients.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24029
References Chen, W., Chen, M., & Qiao, X. (2023). Interaction of lactate/albumin and geriatric nutritional risk index on the all‐cause mortality of elderly patients with critically ill heart failure: A cohort study. Clinical Cardiology, 46(7), 745–756. https://doi.org/10.1002/clc.24029
