Global Immune-Nutrition-Inflammation Index for risk stratification of in-hospital mortality in acute heart failure

Abstract

Purpose: Acute decompensated heart failure (ADHF) is associated with substantial in-hospital mortality and frequent early rehospitalization. This study evaluated the prognostic value of the Global Immune–Nutrition–Inflammation Index (GINI) in hospitalized patients with ADHF.Materials and Methods: This retrospective single-center study included 197 consecutive patients hospitalized between January 2023 and December 2025. GINI was calculated from admission laboratory parameters. The primary endpoint was in-hospital all-cause mortality. Secondary endpoints were composites of all-cause mortality or heart failure rehospitalization within 30 and 90 days after discharge.Results: During hospitalization, 26 patients (13.2%) died. Median admission GINI was higher in non-survivors than in survivors (937.7 [469.3–3118.3] vs. 408.8 [80.6–1592.8]). After multivariable adjustment, GINI was not independently associated with in-hospital mortality (adjusted odds ratio [OR], 1.596; 95% confidence interval [CI], 0.900–2.830), whereas log-transformed troponin remained independently associated with mortality (adjusted OR, 2.910; 95% CI, 1.354–6.252). Among 171 patients discharged alive, the composite endpoint occurred in 52 (30.4%) within 30 days and 106 (62.0%) within 90 days. GINI was not independently associated with either post-discharge endpoint after adjustment for N-terminal pro-B-type natriuretic peptide.Conclusion: Admission GINI reflected increased risk in unadjusted analyses but did not provide independent prognostic information beyond established clinical and cardiac biomarkers.