{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T12:14:43Z","timestamp":1790338483514,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T00:00:00Z","timestamp":1616630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006520","name":"Edwards Lifesciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006520","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Malnutrition is a hallmark of frailty, is common among elderly patients, and is a predictor of poor outcomes in patients with severe symptomatic aortic stenosis (AS). The Geriatric Nutritional Risk Index (GNRI) is a simple and well\u2010established screening tool to predict the risk of morbidity and mortality in elderly patients. In this study, we evaluated whether GNRI may be used in the risk stratification and management of patients undergoing transcatheter aortic valve replacement (TAVR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients with symptomatic severe AS (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0953) who underwent transfemoral TAVR at the University Hospital Schleswig\u2010Holstein Kiel, Germany, between 2010 and 2019 (development cohort) were divided into two groups: normal GNRI\u00a0\u2265\u00a098 (no nutrition\u2010related risk;\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0618) versus low GNRI\u00a0&lt;\u00a098 (at nutrition\u2010related risk;\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0335). The results were validated in an independent (validation) cohort from another high\u2010volume TAVR centre (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0977).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The low\u2010GNRI group had a higher proportion of female patients (59.1% vs. 52.1%), higher median age (82.9 vs. 81.8\u00a0years), prevalence of atrial fibrillation (50.4% vs. 40.0%), median logistic EuroSCORE (17.5% vs. 15.0%) and impaired left ventricular function (&lt;35%: 10.7% vs. 6.8%), lower median estimated glomerular filtration rate (50 vs. 57\u00a0mL\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      ) and median albumin level (3.5 vs. 4.0\u00a0g\/dL) compared with the normal\u2010GNRI group. Among peri\u2010procedural complications, Acute Kidney Injury Network (AKIN) Stage 3 was more common in the low\u2010GNRI group (3.6% vs. 0.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002). After a mean follow\u2010up of 21.1\u00a0months, all\u2010cause mortality was significantly increased in the low\u2010GNRI group compared with the normal\u2010GNRI group (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). This was confirmed in the validation cohort (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Low GNRI\u00a0&lt;\u00a098 was identified as an independent risk factor for all\u2010cause mortality (hazard ratio 1.44, 95% CI 1.01\u20132.04,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.043). Other independent risk factors included albumin level\u00a0&lt;\u00a0median of 4.0\u00a0g\/dL, high\u2010sensitive troponin T in the highest quartile (&gt; 45.0\u00a0pg\/mL),\n                      <jats:italic>N<\/jats:italic>\n                      \u2010terminal pro\u2010B\u2010type natriuretic peptide in the highest quartile (&gt; 3595\u00a0pg\/mL), grade III\u2013IV tricuspid regurgitation, pulmonary arterial hypertension, life\u2010threatening bleeding, AKIN Stage 3 and disabling stroke.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Low GNRI score was associated with an increased risk of all\u2010cause mortality in patients undergoing TAVR, implying that this vulnerable group may benefit from improved preventive measures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.12689","type":"journal-article","created":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T06:45:15Z","timestamp":1616654715000},"page":"577-585","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Frailty in patients undergoing transcatheter aortic valve replacement: prognostic value of the Geriatric Nutritional Risk Index"],"prefix":"10.1002","volume":"12","author":[{"given":"Hatim","family":"Seoudy","sequence":"first","affiliation":[{"name":"Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine University Hospital Schleswig\u2010Holstein Kiel  Kiel Germany"},{"name":"Partner Site Hamburg\/Kiel\/L\u00fcbeck German Centre for Cardiovascular Research  Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baravan","family":"Al\u2010Kassou","sequence":"additional","affiliation":[{"name":"Heart Center Bonn University Hospital 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Angiology and Intensive Care Medicine University Hospital Schleswig\u2010Holstein Kiel  Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4970-2110","authenticated-orcid":false,"given":"Peter","family":"Bramlage","sequence":"additional","affiliation":[{"name":"Institute for Pharmacology and Preventive Medicine  Cloppenburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Katharina","family":"Seoudy","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology, Diabetes and Clinical Nutrition University of Kiel  Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Puehler","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery University Hospital Schleswig\u2010Holstein Kiel  Kiel 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