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老年营养风险指数对行血管内治疗的外周动脉疾病患者预后的影响。

Impact of geriatric nutritional risk index on prognosis in peripheral artery disease patients undergoing endovascular therapy.

机构信息

Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

Department of Vascular Surgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.

出版信息

J Clin Hypertens (Greenwich). 2023 May;25(5):497-503. doi: 10.1111/jch.14659. Epub 2023 Apr 29.

Abstract

The prevalence of peripheral artery disease continues to rise, with major amputations and mortality remaining prominent. Frailty is a significant risk factor for adverse outcomes in the management of the vascular disease. The geriatric nutritional risk index has been used to predict adverse outcomes in lower extremity peripheral artery disease and is a nutrition-based surrogate for frailty. The authors recruited 126 patients with peripheral artery disease who underwent endovascular stent implantation. As in previous reports, malnutrition was diagnosed by the geriatric nutritional risk index. The authors used Kaplan-Meier and multivariate Cox proportional hazards regression analyses to analyze the risk of major adverse limb events, which included mortality, major amputation, and target limb revascularization. There were 67 major adverse limb events during a median follow-up of 480 days. Malnutrition on the basis of the geriatric nutritional risk index was present in 31% of patients. Cox regression analysis showed that malnutrition based on the geriatric nutritional risk index was an independent predictor of major adverse limb events. Kaplan-Meier analysis showed that major adverse limb events increased with worsening malnutrition. Our single-center, retrospective evaluation of geriatric nutritional risk index (as a synonym for body health) correlates with an increased risk of major adverse limb events. Future directions should focus not only on identifying these patients but also on modifying risk factors to optimize long-term outcomes.

摘要

外周动脉疾病的患病率持续上升,主要截肢和死亡率仍然很高。衰弱是血管疾病管理中不良结局的一个重要危险因素。老年营养风险指数已被用于预测下肢外周动脉疾病的不良结局,是衰弱的一种基于营养的替代指标。作者招募了 126 名接受血管内支架植入术的外周动脉疾病患者。与之前的报告一样,通过老年营养风险指数诊断营养不良。作者使用 Kaplan-Meier 和多变量 Cox 比例风险回归分析来分析主要不良肢体事件的风险,主要不良肢体事件包括死亡率、主要截肢和靶肢体血运重建。在中位数为 480 天的随访期间,发生了 67 次主要不良肢体事件。根据老年营养风险指数,31%的患者存在营养不良。Cox 回归分析显示,基于老年营养风险指数的营养不良是主要不良肢体事件的独立预测因子。Kaplan-Meier 分析显示,随着营养不良的恶化,主要不良肢体事件的发生率增加。我们对老年营养风险指数(作为身体健康的同义词)的单中心回顾性评估与主要不良肢体事件风险增加相关。未来的研究方向不仅应侧重于识别这些患者,还应侧重于调整风险因素以优化长期结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1de/10184489/05753b8addc8/JCH-25-497-g002.jpg

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