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老年营养风险指数预测急性缺血性脑卒中患者不良结局——自动化营养不足筛查工具。

Geriatric nutritional risk index predicts poor outcomes in patients with acute ischemic stroke - Automated undernutrition screen tool.

机构信息

Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.

Department of Neurology, Seoul National University College of Medicine, Seoul, Republic of Korea.

出版信息

PLoS One. 2020 Feb 13;15(2):e0228738. doi: 10.1371/journal.pone.0228738. eCollection 2020.

Abstract

BACKGROUND

Premorbid undernutrition has been proven to have an adverse effect on the prognosis of stroke patients. The evaluation of nutritional status is important, but there is no universally accepted screen methodology.

PURPOSE

We aimed to use the geriatric nutritional risk index (GNRI) for evaluating the effect of premorbid undernutrition on short-term outcomes in patients with acute ischemic stroke.

METHODS

A total of 1,906 patients were included for analysis. Baseline characteristics were collected. We evaluated the nutritional status of the patients using the GNRI and body mass index(BMI). The GNRI was calculated as {1.519×serum albumin(g/dL) + 41.7×present weight (kg)/ideal body weight (kg)}. All patients were categorized into four groups on the basis of the GNRI score.

RESULTS

Among the included patients, 546 patients had an unfavorable outcomes. The proportion of patients with moderate and severe risk, assessed in GNRI, was significantly higher in the unfavorable outcome group compared to the favorable outcome group (33.3% vs 15.0%). The increased risk of premorbid undernutrition was associated with an increased risk of unfavorable outcome in a dose-response manner after adjusting for covariates.

CONCLUSIONS

This study demonstrated that GNRI was associated with poor prognosis in patients with acute ischemic stroke. GNRI may be used to screen patients at high risk for unfavorable outcome.

摘要

背景

有研究证明,病前营养不良对脑卒中患者的预后有不良影响。评估营养状况很重要,但目前尚无被普遍接受的筛查方法。

目的

我们旨在使用老年营养风险指数(GNRI)评估病前营养不良对急性缺血性脑卒中患者短期结局的影响。

方法

共纳入 1906 例患者进行分析。收集基线特征。我们使用 GNRI 和体重指数(BMI)评估患者的营养状况。GNRI 的计算公式为{1.519×血清白蛋白(g/dL)+41.7×当前体重(kg)/理想体重(kg)}。根据 GNRI 评分,所有患者被分为四组。

结果

在纳入的患者中,有 546 例患者预后不良。与预后良好组相比,预后不良组中 GNRI 评估为中重度风险的患者比例明显更高(33.3% vs 15.0%)。在校正了混杂因素后,病前营养不良风险增加与不良预后风险增加呈剂量反应关系。

结论

本研究表明,GNRI 与急性缺血性脑卒中患者的不良预后相关。GNRI 可用于筛选预后不良风险较高的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6728/7017988/030a2e4fde20/pone.0228738.g001.jpg

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