Hamamatsu Medical Center, Hamamatsu, Iryo Center, 328 Tomitsuka-Cho, Naka-Ku, 4328580 Hamamatsu, Shizuoka, Japan.
Hamamatsu Medical Center, Hamamatsu, Iryo Center, 328 Tomitsuka-Cho, Naka-Ku, 4328580 Hamamatsu, Shizuoka, Japan.
Orthop Traumatol Surg Res. 2022 Sep;108(5):103327. doi: 10.1016/j.otsr.2022.103327. Epub 2022 May 14.
The Geriatric Nutritional Risk Index (GNRI) is an objective nutritional status assessment tool used for predicting mortality risk in hospitalized patients. However, it is unclear whether GNRI reflects short-term mortality for hip fracture patients after surgery. We examined the usefulness of the nutritional status assessed by the GNRI and identified cutoff scores that predict mortality risk. Does GNRI on admission predict the mortality after surgery for hip fracture?
Evaluation of GNRI could help identify patients at higher risk of 30-day mortality after hip fracture surgery.
This retrospective study used data from 1040 patients who underwent hip fracture surgery. Fatalities within 30 days after hip fracture surgery were investigated. The GNRI was calculated on admission in all patients as follows: 14.89×serum albumin (g/dL)+41.7×body mass index/22. Receiver operating characteristic (ROC) curves were used to calculate the area under the curve (AUC) and the optimal cutoff score that could predict 30-day mortality after hip fracture surgery. This cutoff score was used for comparing the mortality rates between patient groups with a GNRI higher and lower than the cutoff score using Fisher's exact test. Logistic regression analysis was used to determine risk factors of 30-day mortality.
There were 17 fatalities (1.6%) in the cohort. The ROC-AUC value was 0.811, and the cutoff GNRI was 75.4. Mortality was significantly higher in the group with a GNRI<75.4 compared with the group with a GNRI≥75.4 (odds ratio [OR], 22.99; 95% confidence interval [95% CI], 7.55-78.05; p=0.00000004). A GNRI<75.4 was a significant predictor of mortality within 30-days after hip fracture surgery (OR, 27.1; 95% CI, 8.57-85.9; p≤0.0001).
Our results show that nutritional status assessment using GNRI can help predict 30-day mortality among geriatric patients undergoing surgery for hip fracture. The GNRI is a simple and accurate tool for predicting the risk of mortality after hip fracture surgery.
IV; case series study.
老年营养风险指数（GNRI）是一种用于预测住院患者死亡风险的客观营养状况评估工具。然而，目前尚不清楚 GNRI 是否反映了手术后髋部骨折患者的短期死亡率。我们检查了 GNRI 评估的营养状况，并确定了预测死亡风险的截断值。入院时的 GNRI 是否可以预测髋部骨折手术后的死亡率？
评估 GNRI 有助于确定髋部骨折手术后 30 天内死亡率较高的患者。
本回顾性研究使用了 1040 名接受髋部骨折手术的患者的数据。调查了髋部骨折手术后 30 天内的死亡情况。所有患者入院时均计算 GNRI，计算公式如下：14.89×血清白蛋白（g/dL）+41.7×体重指数/22。使用受试者工作特征（ROC）曲线计算曲线下面积（AUC）和预测髋部骨折手术后 30 天死亡率的最佳截断值。使用 Fisher 精确检验比较 GNRI 高于和低于截断值的患者组之间的死亡率。使用 logistic 回归分析确定 30 天死亡率的危险因素。
队列中有 17 例死亡（1.6%）。ROC-AUC 值为 0.811，截断 GNRI 值为 75.4。与 GNRI≥75.4 的组相比，GNRI<75.4 的组死亡率显著更高（比值比[OR]，22.99；95%置信区间[95%CI]，7.55-78.05；p=0.00000004）。GNRI<75.4 是髋部骨折手术后 30 天内死亡的显著预测因子（OR，27.1；95%CI，8.57-85.9；p≤0.0001）。
我们的结果表明，使用 GNRI 进行营养状况评估可以帮助预测接受髋部骨折手术的老年患者的 30 天死亡率。GNRI 是一种简单而准确的预测髋部骨折手术后死亡风险的工具。
IV；病例系列研究。
