Pei Xu, Zhang Yutu, Jiang Dongfeng, Zhang Meng, Fu Junyan, Niu Yang, Tian Mi, Huang Shanshan
Department of Critical Care Medicine and Neurosurgery of Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China.
Department of General Practice of Huashan Hospital, Fudan University, Shanghai, China.
Front Nutr. 2024 Jul 18;11:1410483. doi: 10.3389/fnut.2024.1410483. eCollection 2024.
The Geriatric Nutritional Risk Index (GNRI) is a straightforward and objective tool for nutritional screening in older patients and has been demonstrated to possess prognostic predictive value in several diseases. Nonetheless, there is a lack of research on the nutritional risk associated with brain abscess in the older. This study aimed to evaluate the prevalence of nutritional risk among these patients by GNRI and to investigate its potential prognostic value for clinical outcomes.
From August 2019 to April 2023, 100 older patients diagnosed with brain abscess were enrolled in this single-center prospective cohort study, which evaluated the prognostic value of the Geriatric Nutritional Risk Index (GNRI) in elderly brain abscess patients. Data collected included demographic, and clinical characteristics at admission and calculated the GNRI, and the Glasgow Outcome Scale (GOS) score 6 months post-discharge. A GOS score of 5 was considered indicative of a good recovery, whereas scores ranging from 1 to 4 were classified as poor recovery.
The results revealed that 48% of older brain abscess patients were at risk of malnutrition according to the GNRI. These patients had significantly higher post-admission C-reactive protein (CRP) levels ( = 0.017), more comorbidities ( < 0.001), and higher age-adjusted Charlson Comorbidity Index (aCCI) scores ( < 0.001) compared to those without nutritional risk. Spearman correlation analysis showed that GNRI scores were negatively correlated with CRP levels, comorbidities, and aCCI scores, and positively correlated with Glasgow Outcome Scale (GOS) scores (Spearman's ρ = 0.624, < 0.001). Multivariate logistic regression revealed that lower GNRI values were linked to reduced GOS levels (OR = 0.826, 95% CI: 0.775-0.880). ROC analysis determined a GNRI threshold of 97.50 for predicting poor recovery, with 90.57% sensitivity and 87.23% specificity.
The older brain abscess patients exhibited a high malnutrition risk. GNRI showed an important predictive value for recovery in older patients, which could be helpful in clinical intervention and rehabilitation.
老年营养风险指数（GNRI）是一种用于老年患者营养筛查的简单且客观的工具，已被证明在多种疾病中具有预后预测价值。然而，关于老年人脑脓肿相关营养风险的研究较少。本研究旨在通过GNRI评估这些患者营养风险的患病率，并探讨其对临床结局的潜在预后价值。
2019年8月至2023年4月，100例诊断为脑脓肿的老年患者纳入本单中心前瞻性队列研究，评估老年营养风险指数（GNRI）在老年脑脓肿患者中的预后价值。收集的数据包括入院时的人口统计学和临床特征，计算GNRI以及出院后6个月的格拉斯哥预后量表（GOS）评分。GOS评分为5被认为表示恢复良好，而评分在1至4之间则被归类为恢复不佳。
结果显示，根据GNRI，48%的老年脑脓肿患者存在营养不良风险。与无营养风险的患者相比，这些患者入院后C反应蛋白（CRP）水平显著更高（=0.017），合并症更多（<0.001），年龄校正的Charlson合并症指数（aCCI）评分更高（<0.001）。Spearman相关性分析表明，GNRI评分与CRP水平、合并症和aCCI评分呈负相关，与格拉斯哥预后量表（GOS）评分呈正相关（Spearman's ρ = 0.624，<0.001）。多因素logistic回归显示，较低的GNRI值与较低的GOS水平相关（OR = 0.826，95%CI：0.775 - 0.880）。ROC分析确定预测恢复不佳的GNRI阈值为97.50，敏感性为90.57%，特异性为87.23%。
老年脑脓肿患者表现出较高的营养不良风险。GNRI对老年患者的恢复具有重要的预测价值，有助于临床干预和康复。
