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营养标志物对接受血管内主动脉修复术患者长期死亡率的预后价值

Prognostic Value of Nutritional Markers for Long-Term Mortality in Patients Undergoing Endovascular Aortic Repair.

作者信息

Nishibe Toshiya, Kano Masaki, Matsumoto Ryumon, Ogino Hitoshi, Koizumi Jun, Dardik Alan

机构信息

Department of Medical Management and Informatics, Hokkaido Information University, Ebetsu, Hokkaido, Japan.

Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan.

出版信息

Ann Vasc Dis. 2023 Jun 25;16(2):124-130. doi: 10.3400/avd.oa.22-00118.

Abstract

The relationship between nutritional status and morbidity and death in a number of diseases and disorders has garnered considerable attension. In patients having endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAA), we assessed the prognostic value of nutritional markers of albumin (ALB), body mass index (BMI), and geriatric nutritional risk index (GNRI) for long-term mortality. Retrospective data analysis was done on patients who had undergone elective EVAR for AAA more than 5 years earlier. A total of 176 patients underwent EVAR for AAA between March 2012 and April 2016. The optimal cutoff value of ALB, BMI, and GNRI for predicting long-term mortality was calculated as 3.75 g/dL (area under the curve [AUC] 0.64), 21.4 kg/m (AUC 0.65), and 101.4 (AUC 0.70), respectively. Low ALB, low BMI, and low GNRI as well as age ≥75 years, chronic obstructive pulmonary disease, chronic kidney disease, and active cancer were independent risk factors for long-term mortality. Malnutrition, which is measured by ALB, BMI, and GNRI, is an independent risk factor for long-term mortality in patients receiving EVAR for AAA. Of the nutritional markers, the GNRI can be the most reliable nutritional indicator to identify a potentially high-risk group of mortality after EVAR.

摘要

营养状况与多种疾病和病症的发病率及死亡率之间的关系已引起了相当大的关注。在接受腹主动脉瘤(AAA)血管内动脉瘤修复术(EVAR)的患者中,我们评估了白蛋白(ALB)、体重指数(BMI)和老年营养风险指数(GNRI)等营养标志物对长期死亡率的预后价值。对5年多前接受择期AAA-EVAR手术的患者进行了回顾性数据分析。2012年3月至2016年4月期间,共有176例患者接受了AAA-EVAR手术。预测长期死亡率的ALB、BMI和GNRI的最佳临界值分别计算为3.75 g/dL(曲线下面积[AUC]为0.64)、21.4 kg/m²(AUC为0.65)和101.4(AUC为0.70)。低ALB、低BMI、低GNRI以及年龄≥75岁、慢性阻塞性肺疾病、慢性肾病和活动性癌症是长期死亡率的独立危险因素。通过ALB、BMI和GNRI衡量的营养不良是接受AAA-EVAR手术患者长期死亡率的独立危险因素。在这些营养标志物中,GNRI可能是识别EVAR术后潜在高死亡风险组最可靠的营养指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b578/10288122/aeb812ab7ffa/avd-16-2-oa.22-00118-figure01.jpg

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