Serdar Söner, Department of Cardiology, Health Science University, Gazi Yaşargil Training and Research Hospital, 21070, Diyarbakır, Türkiye e-mail: drserdar_89@hotmail.com

Relationship between Fib-4 score and nutritional status in patients with pulmonary hypertension  

Abstract

Objective: Nutritional status has been associated with poor prognosis in many cardiovascular diseases. Recently, the Fib-4 index, which is a marker of liver cirrhosis risk, has also been investigated in cardiovascular diseases, and its association with poor prognosis has been shown. The goal of this study was to examine the connection between pulmonary hypertension patients' Fib-4 scores and nutritional status.

Methods: 216 individuals who received a pulmonary hypertension diagnosis at our hospital between January 1, 2023, and December 31, 2023, were included in the research. The patients were divided into two groups based on their nutritional status: those who were malnourished (51) and those who were not (162).

Results: Laboratory findings indicated that malnourished patients had significantly lower hemoglobin levels (12.3 ± 2.3 vs. 13.5 ± 2, p=0.002), platelet counts (228 ± 88 vs. 267 ± 123, p=0.044), and albumin levels (3.1 ± 0.4 vs. 4.1 ± 0.4, p<0.001) compared to non-malnourished patients. There was a strong correlation between the FIB-4 index and measures of nutritional status and inflammation.

Conclusions: Malnourished individuals with PAH had greater comorbidity burdens and higher liver fibrosis indices. According to our study's findings, individuals with pulmonary hypertension may benefit from nutritional and liver health evaluations as part of their care to enhance their quality of life and clinical results.

Keywords: Pulmonary hypertension, Fib-4 index, Controlling nutritional status, Prognostic nutritional index

Upper Gastrointestinal Bleeding: A Comparative Analysis of Aims65, News+L, Rockall, and Gbs in Predicting in-Hospital Mortality

Abstract

Background: Acute upper gastrointestinal (GI) bleeding is a common and potentially life-threatening emergency frequently seen in emergency departments. Early and accurate risk stratification is essential for guiding clinical management. This study aimed to assess the effectiveness of various clinical scoring systems and laboratory parameters in predicting in-hospital mortality in patients with upper GI bleeding.

Methods: This retrospective study included patients aged 18 and older diagnosed with upper GI bleeding between January 1, 2016, and January 1, 2019. The Glasgow Blatchford Score (GBS), Pre-endoscopic Rockall Score (PRS), total Rockall Score, AIMS65, and NEWS+L scores were calculated. Laboratory parameters were also analyzed for their association with mortality.

Results: A total of 316 patients were included, with an in-hospital mortality rate of 13.3%. Among the scoring systems, AIMS65 and NEWS+L demonstrated higher predictive accuracy (AUC) for in-hospital mortality compared to PRS. GBS and total Rockall scores also performed better than PRS.

Conclusion: AIMS65 and NEWS+L scores were superior to PRS in predicting mortality. Additionally, low hemoglobin, elevated lactate, high neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios, and increased urea-to-creatinine levels were associated with higher mortality risk.

Keywords: Upper gastrointestinal bleeding, Mortality Score, Endoscopy, Prognosis                   

Pulmoner hipertansiyon hastalarında Fib-4 skoru ile beslenme durumu arasındaki ilişki

Öz

Giriş: Nutrisyonel düzey birçok kardiyovasküler hastalıkta kötü prognozla ilişkilendirilmiştir. Son zamanlarda karaciğer sirozu riskinin bir belirteci olarak kullanılan Fib-4 indeksi de kardiyovasküler hastalıklarda araştırılmış ve kötü prognozla ilişkisi gösterilmiştir. Bu çalışmanın amacı pulmoner hipertansiyon hastalarında Fib-4 skoru ile beslenme durumu arasındaki ilişkiyi araştırmaktı.

Yöntemler: 1 Ocak 2023 ile 31 Aralık 2023 tarihleri arasında hastanemizde pulmoner hipertansiyon tanısı alan 216 kişi araştırmaya dahil edildi. Hastalar beslenme durumlarına göre iki gruba ayrıldı: yetersiz beslenenler (51) ve normal beslenenler (162).

Bulgular: Laboratuvar bulguları yetersiz beslenen hastaların hemoglobin seviyelerinin (12,3 ± 2,3'e karşı 13,5 ± 2, p=0,002), trombosit sayılarının (228 ± 88'e karşı 267 ± 123, p=0,044) ve albümin seviyelerinin (3,1 ± 0,4'e karşı 4,1 ± 0,4, p<0,001) yetersiz beslenmeyen hastalara kıyasla önemli ölçüde daha düşük olduğunu gösterdi. FIB-4 indeksi ile beslenme durumu ve inflamasyon ölçümleri arasında güçlü bir korelasyon vardı.

Sonuç: Pulmoner hipertansiyonlu yetersiz beslenen bireylerde daha fazla komorbidite yükü ve daha yüksek karaciğer fibrozis indeksleri vardı. Çalışmamızın bulgularına göre, pulmoner hipertansiyonu olan bireyler yaşam kalitelerini ve klinik sonuçlarını iyileştirmek için bakımlarının bir parçası olarak beslenme ve karaciğer sağlığı değerlendirmelerinden faydalanabilirler.

Anahtar kelimeler: Pulmoner hipertansiyon, Fib-4 indeksi, Controlling nutritional status, Prognostik nutrisyonel index.                     

Dicle Med J  2025; 52 (2): 219-226

Doi: 10.5798/dicletip.1722822