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Objective <p>The geriatric nutritional risk index (GNRI) is derived from serum albumin, current body weight, and ideal body weight. It is a prognostic indicator for waitlist mortality in patients awaiting lung transplantation (LT). However, its significance according to respiratory function in patients with interstitial lung disease (ILD) awaiting LT remains unclear.</p> Methods <p>We retrospectively analyzed adult patients with ILD listed for LT from donation after brain death between January 2014 and July 2024. They were divided into two groups based on a cutoff of 50% for percentage forced vital capacity (%FVC). A GNRI cutoff value of 93.84 was established based on our previous study.</p> Results <p>Among 253 patients, 123 (48.6%) underwent LT, 81 (32.0%) died while awaiting LT, and 49 (19.4%) remained on the waiting list. The high- and low-%FVC groups included 123 (48.6%) and 130 patients (51.4%), respectively. In the high-%FVC group, 105 (85.4%) and 18 (14.6%) patients had a high and low GNRI, respectively. In the low-%FVC group, 78 (60.0%) and 52 (40.0%) patients had a high and low GNRI, respectively. In both groups, patients with a low GNRI had significantly shorter survival compared with those having a high GNRI (both <i>P</i> = 0.001). In multivariate analyses, low GNRI was an independent predictor of poor prognosis in both the high- and low-%FVC groups (hazard ratio = 4.918 and 2.576, <i>P</i> &lt; 0.001 and = 0.001, respectively).</p> Conclusions <p>The GNRI may serve as a prognostic factor for waitlist mortality in patients with ILD awaiting LT, regardless of %FVC.</p>

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Significance of geriatric nutritional risk index in predicting lung-transplant waiting list mortality of patients with interstitial lung disease regardless of percentage forced vital capacity

  • 期刊论文

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  • 发表日期：

    2026年2月28日

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  • Chihiro Konoeda,
  • Gouji Toyokawa,
  • Miho Yamaguchi,
  • Takafumi Yamaya,
  • Takaki Aakamine,
  • Mitsuaki Kawashima,
  • Mototsugu Shimokawa,
  • Masaaki Sato

摘要

Objective

The geriatric nutritional risk index (GNRI) is derived from serum albumin, current body weight, and ideal body weight. It is a prognostic indicator for waitlist mortality in patients awaiting lung transplantation (LT). However, its significance according to respiratory function in patients with interstitial lung disease (ILD) awaiting LT remains unclear.

Methods

We retrospectively analyzed adult patients with ILD listed for LT from donation after brain death between January 2014 and July 2024. They were divided into two groups based on a cutoff of 50% for percentage forced vital capacity (%FVC). A GNRI cutoff value of 93.84 was established based on our previous study.

Results

Among 253 patients, 123 (48.6%) underwent LT, 81 (32.0%) died while awaiting LT, and 49 (19.4%) remained on the waiting list. The high- and low-%FVC groups included 123 (48.6%) and 130 patients (51.4%), respectively. In the high-%FVC group, 105 (85.4%) and 18 (14.6%) patients had a high and low GNRI, respectively. In the low-%FVC group, 78 (60.0%) and 52 (40.0%) patients had a high and low GNRI, respectively. In both groups, patients with a low GNRI had significantly shorter survival compared with those having a high GNRI (both P = 0.001). In multivariate analyses, low GNRI was an independent predictor of poor prognosis in both the high- and low-%FVC groups (hazard ratio = 4.918 and 2.576, P < 0.001 and = 0.001, respectively).

Conclusions

The GNRI may serve as a prognostic factor for waitlist mortality in patients with ILD awaiting LT, regardless of %FVC.