Although the prognostic nutritional index (PNI) is reported as a prognosticator in patients with heart failure (HF), that is evaluated usually on one occasion, and any changes in PNI during hospitalization are not considered. This study aimed to assess between changes in the PNI during hospitalization and outcomes in patients with acute HF. We enrolled 141 patients (median age, 84 years, 75 male) admitted to our hospital for the treatment of acute HF. The PNI was calculated on admission and at discharge based on the original report. According to the PNI change during hospitalization, patients were classified as either improved (PNI at discharge ≥ PNI on admission) or deteriorated (PNI at discharge < PNI on admission). Primary outcomes were all-cause death or unplanned hospitalization due to HF within the first year. Forty-nine events occurred (19 deaths, 30 HF hospitalizations). The event-free survival rate determined by Kaplan–Meier analysis was significantly higher in patients in the improved group (log-rank test, P < 0.0001), regardless of the PNI value on admission. Multivariate analysis showed that younger age (HR 1.06, 95% CI 1.01–1.11, P = 0.016), higher body mass index (HR 0.90, 95% CI 0.82–0.98, P = 0.021) and the PNI in the improved group (HR 0.30, 95% CI 0.14–0.57, P = 0.0006) were independently associated with favorable outcomes. In conclusion, changes in nutritional status during hospitalization, evaluated using the PNI on admission and at discharge, were independently associated with 1-year outcomes in patients with acute HF.

尽管据报道预后营养指数 (PNI) 是心力衰竭 (HF) 患者的预后指标，但通常只评估一次，并且不考虑住院期间 PNI 的任何变化。本研究旨在评估住院期间 PNI 的变化与急性 HF 患者的结局之间的关系。我们招募了 141 名患者（中位年龄，84 岁，75 名男性）入院治疗急性 HF。PNI 是根据原始报告在入院和出院时计算的。根据住院期间 PNI 的变化，患者被分为改善（出院时 PNI ≥入院时 PNI）或恶化（出院时 PNI <入院时 PNI）。主要结局是第一年内因 HF 导致的全因死亡或计划外住院。发生了 49 起事件（19 例死亡，30 例心衰住院）。Kaplan-Meier 分析确定的无事件生存率在改善组患者中显着更高（对数秩检验，P  < 0.0001），无论入院时的 PNI 值如何。多变量分析显示，年龄较小（HR 1.06，95% CI 1.01-1.11，P  = 0.016），较高的体重指数（HR 0.90，95% CI 0.82-0.98，P  = 0.021）和改善组的 PNI（HR 0.30, 95% CI 0.14–0.57, P  = 0.0006）与有利的结果独立相关。总之，住院期间营养状况的变化（在入院和出院时使用 PNI 进行评估）与急性 HF 患者的 1 年结局独立相关。