Time spent away from bed is associated with oral hygiene and oral function: A cross-sectional and multi-institutional study.

BACKGROUND: Spending time away from bed is important in older adults. Not doing so can lead to functional decline rapidly. OBJECTIVE: To investigate the association between oral function and time spent away from bed in older adults living in nursing homes. METHODS: We enrolled 748 adults aged ≥65 years across eight nursing homes between April 2022 and March 2023. 'Problems with oral hygiene' and 'problems with oral function' were the dependent variables in the multiple regression analyses to determine their association with time spent away from bed. RESULTS: We selected 304 participants (76 men; mean age, 86.3 ± 7.5 years) and divided them into three groups: group S (< 4 h), group M (4 to < 6 h) and group L (≥ 6 h), with 28, 23 and 253 participants, respectively. Comparison of the characteristics between the groups demonstrated significant differences in the Barthel index (p < .001), time spent away from bed (p < .001), history of aspiration pneumonia (p < .001), confirmation of meals and food forms (p = .010), problems with oral hygiene (p = .014), and problems with oral function (p = .002). Based on multiple regression analyses, 'problems with oral hygiene' (p < .001) and 'problems with oral function' (p < .001) were significantly associated with time spent away from bed. CONCLUSIONS: The time spent away from bed was significantly associated with both oral hygiene and function in older adults, suggesting the importance of extending the time that older adults spend away from bed.

Association between sarcopenia and urinary dysfunction in patients with dysphagia.

INTRODUCTION: The objective was to determine the relationship between sarcopenia and urinary dysfunction in patients with dysphagia. MATERIAL AND METHODS: A cross-sectional study was conducted on 460 Japanese Sarcopenic Dysphagia Database participants. Urinary dysfunction was defined as either urinary incontinence or urethral catheter use. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 criteria. Univariate and multivariate analyses assessed the association between urinary dysfunction and sarcopenia, calf circumference (CC), handgrip strength (HGS), and Barthel Index (BI). Logistic regression analysis was performed for urinary dysfunction adjusted for age, sex, setting, and CCI in addition to BI and HGS or CC or sarcopenia (model 1) or FILS and BI (model 2). RESULTS: The mean age was 80.8 ± 10.5 years and urinary dysfunction in 137 participants. Urinary dysfunction was not associated with sarcopenia (123 versus 281, p = 0.440) but was associated with CC (27.4 ± 4.2 versus 28.5 ± 3.9, p = 0.009), HGS (9.7 ± 7.9 versus 14.4 ± 9.3, p < 0.001), and BI (19.9 ± 0.3 versus 20.3 ± 0.2, p < 0.001). Logistic regression analysis showed urinary dysfunction was associated with HGS (OR: 0.968, CI: 0.938, 0.998) and BI (OR: 0.955, CI: 0.943, 0.966). The cutoff was 19 kg for men (sensitivity 0.786, specificity 0.56, Area Under Curve (AUC) 0.689) and 6.1 kg for women (sensitivity 0.493, specificity 0.774, AUC 0.639) in HGS and 27.5 points in BI (sensitivity 0.781, specificity 0.604, AUC 0.740). CONCLUSION: Sarcopenia was not associated with urinary dysfunction. However, HGS and BI were related to urinary dysfunction.

Impact of Early Rehabilitation after Endovascular Treatment for Peripheral Arterial Disease.

Objectives: The prevalence of peripheral arterial disease (PAD) is on the rise, with endovascular treatment being a widely accepted surgical intervention. Patients with PAD often experience reduced activities of daily living (ADL). Therefore, we conducted a retrospective cohort study to investigate the impact of early rehabilitation after endovascular treatment in patients with PAD. Methods: Using data from the JMDC hospital database, the study included 529 patients who were hospitalized for PAD and underwent endovascular treatment. Patients were classified into two independent variables: early rehabilitation group (rehabilitation started within 2 days postoperatively) and control group (rehabilitation started within 3-7 days postoperatively). The outcome measures were the occurrence of hospital-associated disability (HAD) and duration of hospitalization. Results: Unadjusted data showed that the early rehabilitation group (n=469) had fewer HAD events (8.5% vs. 23.3%, P <0.001) and a shorter mean hospitalization duration (4.4 vs. 18.9 days, P <0.001) than the control group (n=60). The difference remained significant after adjustment by propensity score analysis. Conclusions: In patients with PAD, early rehabilitation after endovascular treatment may be beneficial in preventing the development of HAD and reducing the duration of hospitalization.

Nutritional Care for Adults in Nursing Homes: A Scoping Review.

The need for improved nutrition in older adults requiring care has been acknowledged, but, to the best of our knowledge, there is a lack of systematic review and integration of nutritional care studies with older adults in nursing homes. This scoping review aimed to examine the scope and nature of nutritional care research for older adults in nursing homes and to identify research gaps, following the guidelines of the Joanna Briggs Institute. We found varied nutritional care for older adults living in nursing homes, including individualized sessions, such as nutrition counseling, the addition of foods and preparations for increased nutritional intake, and the maintenance of an eating environment, such as feeding assistance and calling. The nutritional care identified in this scoping review also included studies that have improved the nutritional status of older adults in nursing homes by implementing educational programs for care staff. For future research on effective nutritional care for older adults in nursing homes, we suggest evaluating both short- and long-term intervention effects with an adequate sample size.

Development and internal validation of a clinical prediction model to predict independence in daily living at discharge for patients with heart failure: analysis using a Japanese national inpatient database real-world dataset.

PURPOSE: To develop a clinical prediction model (CPM) to predict independence in activities of daily living (ADLs) in patients with heart failure. SUBJECTS AND METHODS: We collected the data of the individuals who were admitted and rehabilitated for heart failure from January 2017 to June 2022 from Japan's Diagnosis Procedure Combination database. We assessed the subjects' ADLs at discharge using the Barthel Index and classified them into independence, partial-independence, and total-dependence groups based on their ADLs at discharge. Two CPMs (an independence model and a partial-independence model) were developed by a binomial logistic regression analysis. The predictors included subject characteristics, treatment, and post-hospitalization disease onset. The CPMs' accuracy was validated by the area under the curve (AUC). Internal validation was performed using the bootstrap method. The final CPM is presented in a nomogram. RESULTS: We included 96,753 patients whose ADLs could be traced at discharge. The independence model had a 0.73 mean AUC and a 1.0 slope at bootstrapping. We thus developed a simplified model using nomograms, which also showed adequate predictive accuracy in the independence model. The partial-independence model had a 0.65 AUC and inadequate predictive accuracy. CONCLUSIONS: The independence model of ADLs in patients with heart failure is a useful CPM.

Malnutrition and cachexia may affect death but not functional improvement in patients with sarcopenic dysphagia.

PURPOSE: To investigate whether two factors, malnutrition and cachexia, affect swallowing function, activities of daily living (ADL), and death in sarcopenic dysphagia. METHODS: Of 467 patients enrolled in the Japanese Sarcopenic Dysphagia Database, 271 met the study eligibility criteria in a retrospective cohort study. Patients were divided into four groups based on whether they had cachexia according to the Asian Working Group for Cachexia (AWGC) criteria and malnutrition according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Multivariate analyses were performed to investigate the differences in changes in the Food Intake LEVEL Scale (FILS) and Barthel Index (BI) and death after follow-up between the malnutrition and cachexia group and the other groups. RESULTS: The mean age was 83.7 ± 8.3 years, 119 (44%) were men and 152 (56%) were women. The median FILS at baseline was 7 and the median BI was 25. A total of 120 (44%) had malnutrition only, 54 (20%) had neither cachexia nor malnutrition, 12 (4%) had cachexia only, and 85 (31%) had both cachexia and malnutrition. Multivariate analyses showed no significant difference between the change in BI (P = 0.688) and the change in FILS (P = 0.928) between the malnutrition and cachexia group and the other groups; however, death increased significantly (P = 0.010). CONCLUSION: Some patients diagnosed with cachexia were not malnourished, although many patients with cachexia were malnourished. While patients with both cachexia and malnutrition did not show significant improvement in ADL and swallowing function compared with patients without both conditions, the number of deaths increased significantly.

Prevalence and prognosis of cachexia according to the Asian Working Group for Cachexia criteria in sarcopenic dysphagia: A retrospective cohort study.

OBJECTIVE: The aim to examine the prevalence and prognosis of cachexia according to the Asian Working Group for Cachexia (AWGC) criteria in patients with sarcopenic dysphagia. METHODS: A retrospective cohort study was conducted with 271 patients diagnosed with sarcopenic dysphagia out of 467 patients enrolled in the Japanese sarcopenic dysphagia database. Cachexia was diagnosed by the AWGC criteria. The AWGC criteria includes chronic diseases, either or both weight loss (2% or more over 3-6 mo) or low BMI (<21 kg/m2), and at least one of the following: anorexia, decreased grip strength (<28 kg in men and <18 kg in women), or elevated C-reactive protein levels (>0.5 mg/dL). Outcomes were death, swallowing function as assessed by the Food Intake LEVEL Scale (FILS), and activities of daily living as assessed by the Barthel Index (BI) at follow-up. RESULTS: The mean age was 84 (±8) y; 152 (56%) were female, and 97 (36%) had cachexia. In univariate analysis, death was significantly more common in the cachexia group (15% versus 2%, P ≤ 0.001). Logistic regression analysis showed that cachexia was independently associated with death (odds ratio: 3.557, 95% confidence interval: 1.010, 12.529). No significant differences were found in the presence or absence of cachexia in the FILS (7 versus 8, P = 0.849) and BI (55 versus 52.5, P = 0.892). CONCLUSIONS: Cachexia was found in 36% of patients with sarcopenic dysphagia, and death was significantly higher in cachexia.

Preoperative versus postoperative ultrasound-guided rectus sheath block for acute postoperative pain relief after laparoscopy: A retrospective cohort study.

Although rectus sheath block (RSB) is routinely used in laparoscopic surgeries to reduce mid-abdominal pain, whether RSB should be performed before or after surgery remains unclear. Herein, the optimal timing for RSB in patients undergoing laparoscopic surgery was investigated. This retrospective cohort study analyzed the data of patients who underwent RSB during laparoscopic procedures at our hospital between January 2013 and December 2018. The primary outcome was the time to rescue analgesia within 24 hours postanesthesia. The patients were divided into preoperative (pre-) and postoperative (post-) RSB groups. A multivariable Cox proportional hazards regression model was used to analyze the time to rescue analgesia in the unmatched and propensity score (PS)-matched patient populations. In total, 609/14,284 patients were included (pre-RSB group, 227 patients; post-RSB group, 382 patients). After PS matching, 97 patients were assigned to both groups. Although the time from extubation to the first analgesic request was not significantly different between the 2 groups (322 vs 294 minutes, P = .57), the patients in the pre-RSB group showed a lower risk of postoperative first analgesic administration after PS matching (adjusted hazard ratio, 0.71; 95% confidence interval, 0.53-0.95; P = .023). Among patients undergoing laparoscopic surgery, those in the pre-RSB group tended to have a longer time to the first analgesic request and had a lower risk of analgesic administration within the first 24 hours than those in the post-RSB group. Thus, performing RSB preoperatively may be preferable.

Hospitalization-associated disability prediction using Hospital Frailty Risk Score in older patients undergoing pancreatectomy.

PURPOSE: Frailty and hospitalization-associated disabilities (HAD) are geriatric conditions that should be managed in older patients undergoing pancreatectomy. The Hospital Frailty Risk Score (HFRS) can evaluate frailty based on medical records and could predict postoperative activities of daily living (ADL) decline. This study aimed to investigate whether HFRS affects the postoperative incidence of HAD in older patients who underwent pancreatectomy. METHODS: This retrospective, observational study used data from a nationwide hospital-based database. We included consecutive patients aged ≥ 65 years who were diagnosed with pancreatic cancer (International Statistical Classification of Diseases, 10th revision code C25) and underwent curative pancreatectomy between April 2014 and August 2020. We evaluated preoperative frailty using HFRS. The primary outcome was HAD following pancreatectomy. Logistic regression analysis was performed for analyzing the impact of frailty on HAD following pancreatectomy. RESULTS: We included 671 patients for the analysis (mean age 74.3 ± 5.6, male 54.8%). The prevalence of intermediate and high risk of frailty with HFRS ≥ 5 was 2.7%. The incidence of HAD was significantly higher in the intermediate- and high-risk groups compared to that in the low-risk group (33.3% vs. 8.4%, p < 0.001). Logistic regression analysis demonstrated that intermediate and high risks of frailty increased the likelihood of HAD (odds ratio, 3.55; 95% confidence interval: 1.12-11.2). CONCLUSIONS: The risk of frailty evaluated using the HFRS increased the likelihood of developing HAD in older patients undergoing pancreatectomy. Future research on effective perioperative interventions for preventing postoperative HAD and enhancing postoperative ADL recovery is warranted.

Relationship between nutritional status and clinical outcomes among older individuals using long-term care services: A systematic review and meta-analysis.

BACKGROUND & AIMS: Nutritional status is a significant issue in an aging society; however, the impact of the nutritional status of older individuals using long-term care services on the caregiving burden remains unclear. This systematic review and meta-analysis aimed to investigate the impact of nutritional issues on adverse outcomes in older individuals using long-term care services. METHODS: We used data from the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Web of Science, CINAHL, and Ichu-shi Web databases. Original articles published in English or Japanese between January 2000 and July 2022 were included. The inclusion criteria were interventional and observational studies on individuals using long-term care services with aged ≥65 years and a focus on body weight or weight loss. Data on adverse outcomes related to caregiving burden, including the number of people requiring care, mortality, complications, activities of daily living (ADL), and quality of life, were collected. RESULTS: The literature search yielded 7873 studies, of which 35 were ultimately included. Seven observational studies investigated mortality outcomes, and seven examined ADL outcomes. The meta-analysis revealed significantly higher mortality rates in individuals classified as underweight (BMI <18.5 kg/m2) than in those with BMI ≥18.5 kg/m2 (risk ratio [RR] 1.49; 95 % confidence interval [CI] 1.31 to 1.73, 0.22; I2 93 %). Further, on categorising the participants based on a BMI cutoff of 25 kg/m2, those with a BMI of <25 kg/m2 had a significantly increased mortality rate (RR 1.21; 95 % CI 1.04-1.40; I2 = 98 %). BMI and weight loss did not affect ADL. CONCLUSIONS: Our findings indicate that underweight and weight loss are significantly associated with increased mortality in older individuals using long-term care services. Therefore, appropriate weight management is recommended for this population. However, further research is necessary owing to the high heterogeneity observed in this study.

Polypharmacy, Potentially Inappropriate Medications, and Dysphagia in Older Inpatients: A Multi-Center Cohort Study.

BACKGROUND: Although the relationship between medication status, symptomatology, and outcomes has been evaluated, data on the prevalence of polypharmacy and potentially inappropriate medications (PIMs) and the association of polypharmacy and PIMs with swallowing function during follow-up are limited among hospitalized patients aged ≥65 years with dysphagia. METHODS: In this 19-center cohort study, we registered 467 inpatients aged ≥65 years and evaluated those with the Food Intake LEVEL Scale (FILS) scores ≤8 between November 2019 and March 2021. Polypharmacy was defined as prescribing ≥5 medications and PIMs were identified based on the 2023 Updated Beers Criteria. We applied a generalized linear regression model to examine the association of polypharmacy and PIMs with FILS score at discharge. RESULTS: We analyzed 399 participants (median age, 83.0 years; males, 49.8%). The median follow-up was 51.0 days (interquartile range, 22.0-84.0 days). Polypharmacy and PIMs were present in 67.7% of and 56.1% of patients, respectively. After adjusting for covariates, neither polypharmacy (ß = 0.05; 95% confidence interval [CI], -0.04-0.13, p=0.30) nor non-steroidal anti-inflammatory medications (ß = 0.09; 95% CI, -0.02-0.19; p=0.10) were significantly associated with FILS score at discharge. CONCLUSION: The results of this study indicated a high proportion of polypharmacy and PIMs among inpatients aged ≥65 years with dysphagia. Although these prescribed conditions were not significantly associated with swallowing function at discharge, our findings suggest the importance of regularly reviewing medications to ensure the appropriateness of prescriptions when managing older inpatients.

Impact of Motivation for Eating Habits, Appetite and Food Satisfaction, and Food Consciousness on Food Intake and Weight Loss in Older Nursing Home Patients.

BACKGROUND: This study analyzed data from the Long-term care Information system For Evidence (LIFE) database to examine the effects of motivation to eat, appetite and food satisfaction, and food consciousness on food intake and weight loss. METHODS: Of the 748 nursing home residents enrolled in the LIFE database, 336 met the eligibility criteria for this cross-sectional study. Motivation to eat, appetite and food satisfaction, and food consciousness were rated on five-point Likert scales (e.g., good, fair, normal, not so good, and not good). We applied Spearman rank correlation coefficient and multiple regression analyses to analyze the relationships between these three items, daily energy and protein intake, and body weight loss over 6 months. RESULTS: The mean participant age was 87.4±8.1 years and 259 (77%) were female. The required levels of care included-level 1, 1 (0%); level 2, 4 (1%); level 3, 107 (32%); level 4, 135 (40%); and level 5, 89 (27%). The mean daily energy intake was 28.2±7.8 kcal/kg. The mean daily protein intake was 1.1±0.3 g/kg. The mean weight loss over six months was 1.2±0.7 kg. We observed strong positive correlations among motivation to eat, appetite and food satisfaction, and food consciousness (r>0.8). These three items were significantly associated with higher daily energy intake but not with daily protein intake. Only appetite and food satisfaction were significantly associated with lower weight loss over six months. CONCLUSION: The observed associations of appetite and food satisfaction suggest that these factors may be more important to assess than motivation to eat or food consciousness among older adult residents of long-term care facilities.

Characteristics and Methodological Quality of the Top 50 Most Influential Articles on Stroke Rehabilitation: A Bibliometric Analysis.

ABSTRACT: This study aimed to conduct a comprehensive review of the top 50 most influential articles on stroke rehabilitation to investigate characteristics, such as the number of citations, year of publication, study design, and research topic, as well as to assess the evidence level and methodological quality. Moreover, we performed a supplementary assessment of the top 10 articles published within the past 5 yrs in the same domain, aiming to discern potential shifts in trends and methodological quality. Web of Science was used to search for articles on stroke rehabilitation. The data extracted from the articles included title, journal impact factor, year of publication, total number of citations, article topic, study design, and others. The level of evidence and methodological quality were assessed by two reviewers. Noninvasive brain stimulation and robotic rehabilitation were frequently discussed in the top 50 articles. We found that there was no difference in methodology quality between the top 50 articles in all years and the top ten articles in the past 5 yrs. Furthermore, the number of citations and citation density were not associated with the methodological quality. The findings suggest that the number of citations alone may not be a reliable indicator of research quality.

Measures for Identifying Malnutrition in Geriatric Rehabilitation: A Scoping Review.

Malnutrition is a common condition in geriatric rehabilitation settings; however, the accuracy and predictive validity of the measures to identify malnutrition have not been established. The current scoping review followed the Joanna Briggs Institute's evidence synthesis manual and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews checklist. Literature published through September 2023 was searched using MEDLINE and CINAHL. The inclusion criteria selected studies reporting malnutrition measures, which include static body weight and weight loss. Identified tools were classified as nutritional screening tools, nutritional assessment tools, or diagnostic criteria. The domains of each tool/criterion and their accuracy and predictive validity were extracted. Fifty-six articles fulfilled the inclusion criteria, and six nutritional screening tools, three nutritional assessment tools, and three diagnostic criteria for malnutrition were identified. These measures consisted of various phenotypes, e.g., weight loss, causes such as inflammation/disease, and risk factors of malnutrition, e.g., functional impairment. The predictive validity of nutritional screening tools (n = 6) and malnutrition diagnostic criteria (n = 5) were inconsistently reported, whereas those for nutritional assessment tools were scarce (n = 1). These findings highlight the need to distinguish the functional impairment of nutritional origin from that of non-nutritional origin in nutritional assessment procedures, and the need to study the accuracy and the predictive validity of these measures in geriatric rehabilitation patients.

Effects of weekend rehabilitation on vertebral compression fractures in the elderly.

INTRODUCTION: This retrospective cohort study aimed to investigate the effect of rehabilitation and without weekend therapy on Activities of daily living (ADL) and readmission in vertebral fracture patients aged 60 years and older. METHODS: The present study used a hospital-based database created by JMDC Inc. The JMDC hospital-based database is an epidemiological database that has been storing medical claims and Diagnosis Procedure Combination survey data. This study included 40,743 admitted patients aged 60 years or older who were admitted for rehabilitation purposes with a diagnosis of compression fracture of the thoracic and/or lumbar spine based on a previous diagnostic survey. We extracted the medical information from the database. Patients who received rehabilitation 7 days a week were classified into two groups: the "weekend rehabilitation group" and "nonweekend rehabilitation group." To reduce confounding effects related to differences in patient background, we used propensity score with multiple logistic regression models. Analysis of the JMDC database was conducted with the approval of the Institutional Review Board (approval number: 1228-1). Because all data were anonymized, informed consent was not required. RESULTS: Propensity score matching resulted in 13,790 cases being included in the analysis. Barthel index (BI) at discharge, change in BI, and readmission were significantly different between the weekend rehabilitation and nonweekend rehabilitation groups. Multiple logistic regression analysis suggested a reduced odds of readmission with weekend rehabilitation (odds ratio = 0.907, 95% confidence interval [CI] = 0.843-0.975, p-value = 0.008). Furthermore, greater changes in BI and BI at discharge were associated with the effect of weekend rehabilitation (unstandardized [B] = 3.922, 95% CI = 2.925-4.919), (unstandardized [B] = 3.512, 9% CI = 2.424-4.6), respectively. CONCLUSIONS: Weekend rehabilitation was considered as an important part of the treatment program to acquire ADL and to prevent readmission.

Nutritional Care and Rehabilitation for Frailty, Sarcopenia, and Malnutrition.

Frailty, sarcopenia, and malnutrition are highly prevalent among the older population [...].

Association between Japanese Diet Adherence and Muscle Weakness in Japanese Adults Aged ≥50 Years: Findings from the JSTAR Cohort Study.

Japanese diet adherence has been inversely correlated with muscle weakness. In this study, we aimed to validate that association. Longitudinal data from 1699 individuals aged ≥50 years (mean age 62.5 ± 6.9 years, 50.4% female) at two time points (2007 and 2011) were used. Participants without muscle weakness from several regions in Japan were included. The 12-component revised Japanese Diet Index (rJDI12) classified by tertiles assessed adherence to the Japanese dietary pattern. Muscle weakness was defined as a handgrip strength of ˂18 kg for females and ˂28 kg for males based on the Asian Working Group for Sarcopenia criteria 2019. A multivariate logistic approach was used to determine the relationship between rJDI12 tertile and the occurrence of muscle weakness by calculating the odds ratio (OR) and its 95% confidence interval (95% CI) throughout the observation period. Muscle weakness was negatively correlated with the highest rJDI12 tertile (OR [95% CI] 0.891 [0.814, 0.973] for T3). This association was consistent in sensitivity analyses with multiple imputations of missing values. Closely following the Japanese dietary pattern appears to reduce the occurrence of muscle weakness among the aging population in this study, suggesting it may prevent frailty and sarcopenia in the aging population.

Predictive Value of the Hemoglobin-Geriatric Nutritional Risk Index in Patients with Heart Failure.

Malnutrition prevails among patients with heart failure (HF), increasing the likelihood of functional decline. We assessed the predictive value of the Hemoglobin-Geriatric Nutritional Risk Index (H-GNRI)-combining hemoglobin and the Geriatric Nutritional Risk Index (GNRI)-on prognosis in older patients with HF. We used the JMDC multicenter database to examine the potential associations between malnutrition risk and other outcome measures. The patients were categorized as low- (H-GNRI score = 0), intermediate- (H-GNRI score = 1), or high-risk (H-GNRI score = 2) based on their H-GNRI scores. The primary outcome measure was the Barthel Index (BI) gain; the secondary outcomes included the BI at discharge, the BI efficiency, length of hospital stay, in-hospital mortality, discharge to home or a nursing home, and hospitalization-associated disability. We analyzed 3532 patients, with 244 being low-risk, 952 being intermediate-risk, and 2336 being high-risk patients. The high-risk group of patients had significantly lower BI values at discharge, lower BI gains, reduced BI efficiency values, and prolonged hospital stays compared to those in the low-risk group. The high-risk patients also had higher in-hospital mortality rates, lower rates of discharge to home or a nursing home, and greater incidences of a hospitalization-associated disability in comparison to the low-risk group. The H-GNRI may serve as a valuable tool for determining prognoses for patients with HF.